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GP Training… it’s all about quality and managing risk

I marvel at the Australian GP Training System. I marvel because as GP Supervisors we are driven by more than money and fear. Despite the risk to our patients, our careers, our businesses and ourselves, we take on the commitment to supervise registrars. These junior doctors arrive in our practices, treating our patients with variable degrees of competency. As this management can occur behind closed doors adverse events may occur despite the most rigorous supervision and is a cause for great anxiety in most training practices.

It would be easy to batten down the hatches and just treat patients. It would be simpler to only employ experienced fellowed GPs to work in our practices. The risk can be huge, expensive and yet, despite all of that, GP Supervisors continue to accept GP registrars into our practices because of the promise they represent. The opportunity to influence, develop, mentor and mould them – to become our replacements, our doctors, our practice owners, our supervisors; the future.

The conversation in the medical press and social media reflects the pressures being experienced across the sector. It is a difficult time to be a GP and even more difficult to be a practice owner and supervisor. With declining incomes it’s not surprising that some focus their attentions on money.

As we enter the NTCER negotiations in 2018, GPSAs mandate from the membership is clear: We’re under pressure. Our income has been in decline. We have so many things to be concerned about… like patient safety, maintaining best practice, CPD, attendance to medicolegal matters, RTO compliance paperwork and registrar wellbeing.

GPSA are here for every last Supervisor, through every experience and always looking for new ways to assist in making your work lives better, easier and more rewarding. With over 5000 supervisors caring for our communities and our registrars nationally, its clearly not a role that all of the 34,000 plus GPs care to perform. It is therefore incumbent upon the AGPT community to look after our relatively small, but diligent volunteer supervisor workforce in the same way we look after our registrars.

Recognising the risk management strategies that practices and supervisors need to put in place and always to remain vigilant as well as caring and supportive. Despite characterisations to the contrary, payment of percentages on 13-week cycles is not compulsory, nor exploitative. You are at liberty to manage your exposure to risk as a practice. It’s a business decision and an item for negotiation. Due to the challenging circumstances we assist members to navigate with their registrars, GPSA certainly recommends practices pay base salary payments every fortnight with the bonus percentage top ups every 13 weeks. A bonus that is unique to training doctors in GP land.

GPSA have no interest in seeing practices do wrong by their registrars – registrars after-all become tomorrow’s supervisors. We welcome a dialogue about quality and risk management as we progress towards the transition of training to the colleges and the next NTCER. But we need to also understand that training must be sustainable and if the costs outweigh the benefits then supervisors and training practices will walk away. We can only hope that our registrars are equipped to lead the discussion around quality and risk management. Are they in our practices to primarily earn or learn?

Steve Holmes
Chair – GPSA