Single employer model headache for practice managers

Practice managers would face a myriad of administrative headaches if a single employer model is introduced to GP training, according to Victorian practice manager Leonie Chamberlain.

Ms Chamberlain, the first practice manager elected to the General Practice Supervisors Australia (GPSA) board, believes a single employer model would negatively impact general practices and the registrar training experience.

The proposed single employer model seeks to address portability of leave for registrars as they move between general practices during their training terms. It is not clear which organisation would take on the single employer role, replacing practice-based employment.

Ms Chamberlain believes “it’s only reasonable that registrars can access portability of leave”, but a solution should be found under the current employment arrangements with general practices.

“If the point of introducing a single employer model is to solve registrars’ concerns about the portability of their leave, it may fix one issue but create 100 more,” Ms Chamberlain, who was appointed to the GPSA board in November, said.

“Whilst having a single employer model may solve the issue of portability of leave, we can also solve it under the current model of practice-employed registrars. We are just as capable as other industries which have been able to solve this problem.”

Building relationships

Ms Chamberlain believes funding to establish and administer a single employer model would be better spent on supporting general practices to continue employment responsibility.

“From a cost perspective, why spend money on something that is already done very well at no cost [to the Department of Health],” she said.

“At the moment all the costs of the employment of registrars are absorbed by the training practices; surely another layer of bureaucracy is not needed. For example, our general practice [Blackburn Clinic] currently employs one registrar; we manage the registrar’s payroll and leave, and in doing so we also get to develop a relationship with that person.

“In my 18 years with my practice we have had four registrars who have later become practice principles. Under a single employer model, a registrar and practice will have less involvement and commitment to each other, and relationship building, which is so important to succession planning, may be diminished.”

Victorian practice manager and new GPSA board member Leonie Chamberlain.

Ms Chamberlain believes supervisors would still provide quality training to their registrars under a single-employer model, but the number of quality training practices raising their hand to supervise registrars would decrease.

“No practice takes on a registrar to make money: we are doing our bit to make sure there are quality doctors for our communities.

“Supervisors are passionate about teaching and want to ensure the professionalism and longevity of the profession. Ensuring there are quality doctors coming through into general practice is a major priority.

“Another reason training practices take on registrars is that the relationship provides a wonderful opportunity for both parties to see if they are a good match,” Ms Chamberlain said.

“Registrars who fit well into a practice are a great resource to draw upon for workforce and succession planning.

“This relationship also serves as a terrific networking tool for registrars, helping them find the right practice to commence the next stage of their working life.”

Administration overload

Ms Chamberlain believes the single-employer model will create extra layers of administration for practice managers.

“I think it will create more work because we are going to have another entity to deal with.

“We already deal with RTOs, Medicare and WorkCover and others. If we need to negotiate with another entity and we don’t know how much control we will have, it’s going to be difficult.”

Ms Chamberlain is also concerned about who would be responsible for performance and fatigue management, and reporting registrars’ training hours to ensure they meet college requirements.

“Do we report to the employer or the RTO?” she asked.

“If we are not the registrar’s employer, what rights or obligations will we have if there are performance issues?

“For registrars in rural practices who also work at the regional hospital, who will be responsible for their fatigue management?”

GPSA believes a single employer model may also have unexpected negative consequences for registrars. For more information, download