Is working as a solo GP unsafe?

regular birthday cakes. We can seek advice with a tap on the door.

I am not sure what is the best size for a practice. How many GPs? Three seems a bit small; 15 is more

like a business. Perhaps six or

seven full-time equivalents is near

the mark, but that number reflects

my own experience and bias.

But is there still a place or a

necessity for solo medical practice,

and what draws some GPs to this

style of practice?

I do not pretend to have exper-

Dr Jon Fogarty GP on the NSW Central Coast.

tise in this area, and these practitioners can speak for themselves.

I suspect some may be drawn to

the very elements of solo practice

PICTURE CREDIT

that drive others from it. Some will value independence above all else.

They know they can hire the staff they want and take leave of those who do not suit them.

They are not drawn to accred-

I started practice as a solo GP in

itation and feel comfortable with

1980 and was surrounded by many

their own skill set. Some are sup-

other colleagues working alone. It

ported by excellent allied health

was not the only option, but it was

and other staff.

seen as an entirely normal one.

Some will be providing superb

Now, it would be perceived as a bit

clinical care in isolated areas where

bizarre and certainly risky.

I certainly could not practise and

By 2021, about 2 % of GPs worked

where my limited skill set would be

in solo practice. It is almost cer-

quickly found out.

tainly fewer now. 1

These GPs will be linked to col-

The reasons for this transition

leagues via the net, and for them,

are many and largely self-evident.

advice or collegiate support is just a

GPs have retreated from solo

click away.

practice partly because it was not

For others, isolated practice is a

financially viable.

minefield. They may feel trapped

Who could afford to rent rooms

Solo practitioners needed a

the increasing demands of the spe-

call for a solo practitioner.

in a remote community, or in a big

and pay for a receptionist, part-

friendly and willing colleague to

cialty itself.

GPs cannot do all things. Some

city, trapped by personal circum-

time practice manager and practice

cover them for holidays and after-

Accreditation is not mandatory

will be good at procedures, and

stances or a profound commitment

nurse when working on their own?

hours care. Locums were always

but is widely seen as an acceptable

some will not. Some have special

to a community they have served

Solo practice was not encour-

difficult to get and rarely entirely

industry standard.

skills in women’ s health, and oth-

for many years.

aged by the Federal Government,

satisfactory.

Electronically controlled,

ers in palliative care. Some are

There are plenty of risks for GPs

and over the years, various finan-

Group practices could cover

height-adjusted couches for oper-

available to work two days a week,

in group practices. But there are

cial inducements were dangled in

their own gaps. In time, after-hours

ating rooms are considered stand-

and some like to work on Saturdays.

special risks for solo GPs.

front of practitioners to encourage

A solo GP cannot be all these

There are risks of professional

them to join together. There was a time when corporate practices would pay industrial sums of money for a local GP to join

General practice has increasingly become a part-time career.

things, but their community may expect these things. Group practice has a greater capacity to meet community expectations.

isolation, risks of mental health impacts and, occasionally, the risk of developing an inflated sense of competence without the ben-

the‘ team’, although with that tran-

We cannot be all things to all

efit of a challenge to that view or

sition came onerous and sometimes

care in major centres was trans-

ard. A dedicated vaccination fridge

people, but it is reasonable to

a collegiate and timely tap on the

joyless working conditions.

ferred, for better or worse, to out-

is essential.

remember that we are there for the

shoulder.

With the move to group practice

side providers.

High-quality, up-to-date soft-

community’ s benefit, not the other

For most, the move to group

came( sometimes) collegiality. With

General practice has increas-

ware and hardware are required

way around.

practice makes sense. It serves our

it went independence.

ingly become a part-time career.

to meet present expectations for

When group practice works well,

community well.

Group practice( sometimes) pro-

Three or four days a week at the

medical records. Familiarity with

it is a joy. We can be surrounded

There will be no going back.

vided a more viable financial structure than solo practice. It was for

practice is the norm, and for some, it is less than this. Group practice

PRODA( Provider Digital Access) and MyMedicare is essential to

by admin staff, nursing staff and allied health colleagues whose

1 Med J Aust 2021; 10 May.

the managers to run the business,

allows this. Solo practice does not.

maintain funding.

friendship and opinions we value.

leaving the GP to practise medicine( so went the narrative).

Perhaps the greatest push to group practice has resulted from

To meet these and countless other expectations is a daunting

We can share the load. We can share laughter, occasional tears and

Visit ausdoc. com. au for more

Australian Doctor team

To email staff, use the following format: firstname. surname @ adg. com. au

Editor: Paul Smith( 02) 8484 0795 Medical editor: Dr Kate Kelso BMed FRACGP How to Treat editor: Dr Claire Berman MBBCh Clinical editor: Rada Rouse

Political editor: Antony Scholefield Chief of staff: Rachel Carter 6minutes news editor: Carmel Sparke Chief reporter: Heather Saxena Senior reporters: Mohana Basu Jamie Thannoo

Junior reporter: Ciara Seccombe Production editor: Sophie Attwood Senior content producers: David Dombrovskis Robert Santos Senior website manager: Stacey Shipton Senior graphic designer: Edison Bartolome

Managing director: Bryn McGeever Sales and marketing enquiries: 1300 360 126 Classified pages bookings:( 02) 8484 0666 gpclassifieds @ adg. com. au Production manager— client services: Eve Allen

The views expressed in this publication are not necessarily those of Australian Doctor Group.

Australian Doctor is an independent publication serving the needs of Australia’ s GPs. It has no affiliation with any medical organisation or association, and our editorial content is free of influence from advertisers.

Australian Doctor is sent free to full-time GPs in private practice and certain prescribing and staff specialists. It is available to other readers on subscription for $ 390.00 pa including GST. Overseas rates apply. Phone 1300 360 126. Average net distribution period ending March 2023: 15,918.

Australian Doctor is published 12 times a year by Australian Doctor Group.

Level 12, 117 York Street, Sydney, NSW, 2000 Ph:( 02) 8484 0666 Fax:( 02) 8484 0633 Email: customer. service @ adg. com. au www. ausdoc. com. au( Inc in NSW) ACN 132 719 861 ABN 94 615 959 914 ISSN 1039-7116 © Copyright 2023 www. adg. com. au