In 2011, after 13 years as a GP principal and trainer, and having held a number of regional and national roles, I felt ready for my next career challenge. I resigned from my practice to explore other opportunities.
These could have been anywhere, although having spent a year in Australia on sabbatical, there was a natural attraction to head 'down under'.
I moved to Australia's capital, Canberra, in March 2012 with my family to take up a role as medical director with Ochre Health.
This has been an outstanding opportunity to be involved in the development of new clinics, collaborating with University of Canberra and other academic institutions.
Clinically, general practice in Australia is not dissimilar to the UK. The types of cases are similar, but with potential for wider scope, for example minor injuries and plastering, particularly in rural areas.
The role of nurses here is much more variable and is evolving. The gatekeeping role of the GP has less of a focus in Australia and there is more clinical freedom in prescribing and making referrals. Access to diagnostics is also much easier.
The workload is less intense here, with most GPs offering 15-minute appointments and the demand for home visits not as great. The amount of paperwork GPs are required to do in Australia is significantly less in comparison with the UK.
Funding for general practice
General practice is primarily funded by federal government rather than state government and has two elements - incentive payments to recognise accredited general practices providing comprehensive, quality care, and fee-for-service, which is the predominant source of revenue.
Australia's healthcare system, Medicare, offers Australian citizens and permanent residents rebates for services provided to them by healthcare professionals with a Medicare provider number.
Doctors charge patients a fee. This may be the same as the Medicare rebate and can be directly charged to Medicare on behalf of patients (known as bulk billing).
Alternatively, the fee may be higher than the rebate, in which case patients make up the difference.
In reality, most doctors offer mixed billing, where certain groups, for example children and pensioners, may be bulk billed and others privately billed.
The organisational structure for practices is similar to the UK and GP principals, companies or 'corporates' and other organisations may own and operate practices, with a small number offering specific services, such as flying doctor services or Aboriginal health services.
GPs may be salaried, but most are independent contractors. They run their 'clinical practice' from a centre and the organisation operates the centre. The operator charges the clinician a service fee, usually a percentage of their gross billings, typically in the range of 50-70%, depending on other incentives offered.
The volume of patients seen heavily influences earning potential and GPs need to be mindful of this, as sickness and annual leave is unpaid.
Opportunities for UK GPs
As an international medical graduate, your qualifications have to be recognised for you to work as a GP in Australia. The location you want to work in has to be deemed a district of workforce shortage and a visa is required.
The two medical colleges listed in the resources below provide more information on qualifications, including the categories of the Specialist Pathway Program, which recognises prior training and experience.
GPs who fall into category 1 have no need of additional examinations, training or supervision.
Most doctors come to Australia on a temporary visa or '457'. Recruitment companies help GPs find a job and navigate what can be a regulatory and bureaucratic minefield. Doctor Connect (see resources below) is a rich source of information.
|Moving to Australia: useful resources|
The 457 gives children permission to enter the education system and spouses a right to work in Australia, but does not allow access to health services beyond reciprocal arrangements between countries, so health insurance is essential.
There is a good choice of public and private schools. The opportunities for spouse employment are also good, with unemployment rates lower than the UK, although spouses would need to have their qualifications recognised here.
The climate is great and there is so much to explore. In Canberra, we are a couple of hours away from the Snowy Mountains and the beaches.
Australia offers a fantastic opportunity for those wanting to work and live here. Although the healthcare system is undergoing reform, there is greater clinical freedom and earning potential than in the UK, with a more balanced workload leaving plenty of time to explore this vast continent.
- Dr Dawda is medical director, Ochre Health, Canberra