Teaching GP Registrars, the Business of General Practice – GPTEC 2019
This was a fantastic session for me and hopefully, the supervisors who contributed to the discussion of this very important but poorly addressed subject.
While we know it is important, very few of us go beyond teaching registrars about the Medicare item numbers to what lies beneath and supports the practice they are working in, and allows them to generate income.
Registrar’s understanding of the financial aspects of running a General Practice are quite poor, as evidenced by the recent challenges in NTCER negotiation with expectations and financial reality of General Practice business being significantly disparate.
If registrars are taught early, it can build a better understanding and manage expectations which are not always realistic, in the context of a Medicare freeze/squeeze and rising costs that all practices face. This is especially so in GP teaching practices whose burden of supervision in financial terms has not been fully supported and indeed has been static for twenty years despite rising practice costs and compliance demands.
Many issues were identified during the session, that are not readily apparent to registrars and these include;
- Practice supports – Nursing, IT, Financial, Legal, Insurance – all of which come at a cost and ongoing review and training requirement
- Responsibilities and Liabilities of practice ownership
- Complexities of employment arrangements – various types with different implications, risks and responsibilities
- Payroll tax
- Building ownership versus renting issues
- HR management
- OH & S, Accreditation, Compliance with regulatory authorities
- Complexities of partnership arrangements and different models
- Different business structures
Glen Wallace, CEO of GPSA (GP Supervisors Australia) provided an excellent presentation at GPTEC 2019 which we viewed demonstrating where the money goes that is left after the registrar takes their percentage and the myriad costs it needs to cover.
It also the core business domains of General Practice – Culture, Revenue and Recruitment and how a successful practice requires a lot of investment in time and dollars to establish itself in these areas.
It is presented in a manner that clearly illustrates to registrars what has gone into the practice that makes it successful and it doesn’t come for free. It does take the discussion away from purely financial to the cultural aspects of quality General Practice and moves Registrars from the “me” to “we” way of thinking when they become part of a practice.