Review of the National Rural Locum Program - Final Report - April 2011

Attachment 4: Demographics of the rural medical workforce

Page last updated: 04 July 2012

GP Shortages

According to the Medical Practice in Rural and Remote Australia: National Minimum Data Set 30 November 2009, the number of medical practitioners practising in RRMA 4 to 7 locations has been steadily increasing since 2002 (see Figure 2).

Rural and remote communities generally have a relatively low ratio of GPs proportional to their population. National figures for GPs Full Time Equivalent (FTE) per 100,000 population across different geographic areas are as follows:17

ASGC-RA Classification
FTE GPs per 100,000 population
Major cities
97.0
Inner regional
83.1
Outer regional
74.2
Remote
68.2
Very remote
47.1

Figure 19: GPs Full Time Equivalent (FTE) per 100,000 population

GP Shortages

Overall numbers of practitioners working in RRMA 4 -7 locations (now ASGC-RA 2 to 5) has been steadily increasing since 2002 and as at 30 November 2009 there were 4753 which represents and increase of 71 practitioners from the previous year.

Trends of change November 2002 to November 2009

2002
2003
2004
2005
2006
2007
2008
2009
Total practitioners
3903
4047
4186
4317
4345
4482
4682
4753
Percent female
28.4
29.7
29.7
30.0
30.5
32.2
33.0
33.2
Percent male
71.6
70.3
70.3
70.0
69.5
67.8
67.0
66.8
Average age female
42.19
42.6
43.4
43.9
44.3
44.7
45.0
45.8
Average age male
47.72
48.01
48.6
49.0
49.2
49.5
49.7
50.5
Average age (all)
46.65
46.44
47.1
47.5
47.7
48.0
48.2
49.0
Average GP clinical hours
37.67
37.08
36.54
36.2
36.7
36.1
35.9
35.7
Average total hours
46.65
46.65
43.68
44.1
44.4
44.4
43.7
43.9
Average length of stay in current practice (years)
8.29
9.15
8.25
8.1
8.27
8.2
8.17
8.38
*Proceduralists General Anaesthetics
456
435
459
463
445
431
488
438
*Proceduralists Obstetrics (Normal delivery)
706
638
657
661
622
599
623
583
*Proceduralists Operative surgery
287
287
304
283
275
268
282
258
*Known Proceduralists (practising in at least one procedural field)
935
902
933
929
907
896
934
862
*Proportion of rural practitioners providing procedural services
24.0
22.1
22.3
21.5
20.9
20.0
19.9
18.1
Proportion of practitioners providing emergency care services
41.7
46.6
46.85
41.4
49.5
48.5
41.8
44.9
Proportion of practitioners providing Aboriginal health services
20.5
22.8
19.0
21.4
23.6
23.7
23.0
23.5
Proportion of GPs working in solo practices
16.6
15.8
15.7
14.5
14.6
12.7
13.1
12.1
Proportion of GPs working in group practices
83.4
84.2
84.3
85.5
85.4
87.3
86.9
87.9

Figure 20: Trends or changes to in medical practice and rural and remote Australia18

The table below shows the number of practitioners by State and Territory and RA location. NSW has the largest number of practitioners overall and RA 2 is the location with the largest number of practitioners.

StateRA 1RA 2RA 3RA 4RA 5Total
NSW
0
949
324
28
2
1303
NT
0
0
5
59
29
93
Qld
173
532
337
89
38
1169
SA
0
192
168
49
8
417
Tas
0
64
114
6
3
187
Vic
2
708
229
6
0
945
WA
19
217
220
126
57
639
Total
194
2662
1397
363
137
4753

Figure 21: Practitioner numbers by State and Territory and ASGC-RA19

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Specialist shortages

Rural and remote communities generally have a relatively low ratio of specialist medical practitioners proportional to their population.

ASGC-RA Classification
FTE specialists per 100,000 population
Major cities
122.0
Inner regional
56
Outer regional
38
Remote/very remote
16

Figure 22 : FTE specialists per 100,000 population by ASGC-RA

GP Proceduralist shortages

The GP proceduralist is important in rural and remote medicine because of the lack of population to support sub-specialties; however the latest data demonstrates the proportion of rural practitioners providing procedural services has been decreasing since 2002.

It is difficult to enumerate the number of rural and remote GP proceduralists providing procedural services in RRMA 4 to 7 locations due to non-respondents to the workforce survey used to gather elements of the MDS report. However the known number of practitioners providing specified procedural services as at 30 November 2009 is detailed in the tables below.

Table 11: Number of practitioners undertaking procedural work by type and state or territory

Procedures
NSW
NT
QLD
SA
Tas
VIC
WA
National*
Anaesthetics general
98
2
84
61
0
92
101
438
Obstetrics Normal delivery
109
3
127
78
5
123
138
583
Surgery Operative
77
2
61
26
3
52
37
258
Known Proceduralists**
190
5
173
115
6
176
197
862
Total Practitioners
1303
93
1196
417
187
945
639
4753

Table 12: Number of practitioners undertaking procedural work by type and RRMA

Procedures
RRMA4
RRMA5
RRMA6
RRMA7
National*
Anaesthetics general
106
264
28
40
438
Obstetrics Normal delivery
151
318
64
50
583
Surgery Operative
70
154
14
20
258
Known Proceduralists**
218
490
76
78
862
Total Practitioners
1670
2463
295
325
4753

* GPs practising in RRMAs 4-7
** GPs practising in at least one procedural field

Figure 23: Number of practitioners providing procedural services by type, state or territory and RRMA

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GP Proceduralist shortages

Of the 862 procedural practitioners, 323 (37.5%) perform multiple procedures. A Venn diagram illustrating practitioners undertaking single or multiple procedures is displayed at Figure 41 below.


Figure 24: Venn diagram illustrating numbers undertaking single or multiple proceduresD

Figure 24: Venn diagram illustrating numbers undertaking single or multiple procedures

Types of Practices

The number of GPs working in each practice type by RRMA is also important data in trying to quantify the potential number of locums which may be required.

Table 17: Practice type by RRMA

RRMA
Solo
Group
Number
Percentage
Number
Percentage
RRMA 4
122
7.5
1512
90.2
RRMA 5
340
14.2
2046
85.8
RRMA 6
18
6.6
154
93.4
RRMA 7
76
25.3
215
68.0
Total
556
12.1
4027
84.7

Figure 25: Practice type by RRMA

Leave wanted versus leave taken

Respondents to the survey for the Minimum Data Set were asked to indicate the number of weeks leave desired each year and the number of weeks actually taken. Data for valid responses indicate that there is an average of 1.5 week deficit between annual leave wanted and annual leave taken.

Number
Minimum
Maximum
Mean
Std. Deviation
Annual leave taken
2400
0.50
10
4.56
2.05
Annual leave wanted
1640
1.00
10
6.10
1.86

Figure 26: Average leave wanted and average leave taken in weeks

17. RDAA Factsheet 1/2010 The medical workforce shortage in rural and remote Australia: The Facts
18. Medical Practice in Rural and Remote Australia: National Minimum Data Set 30 November 2009
19. Medical Practice in Rural and Remote Australia: National Minimum Data Set 30 November 2009