The evolution of the general practice workforce in Australia, 1991-2003

Objective: To examine changes between 1991 and 2003 in the characteristics of active recognised general practitioners in Australia. Design: We compared self-reported GP characteristics from the 1990-91 Australian Morbidity and Treatment Survey (AMTS) with those from the 1999 and 2003 Bettering the Evaluation and Care of Health (BEACH) surveys, after standardisation for age and sex to the respective sample frames. AMTS and BEACH are cross-sectional, paper-based, national surveys. Participants: Three random samples of 473 (1990-91), 980 (1998-99) and 1008 (2002-03) GPs who had claimed at least 1500 A1 (ie, general practice) Medicare items in the preceding year (in the AMTS) or 375 general practice Medicare items in the preceding 3 months (in the BEACH surveys). Main outcome measures: Changes in distribution of GP sex, GP age, number of sessions per week, practice size and location, country of graduation, and postgraduate training. Results: Between 1991 and 2003, the proportion of female GPs rose from 19.3% to 35.2%; GPs aged <35 years dropped from 22.3% to 10.0%, and those aged greater than or equal to55 years increased from 21.4% to 31.6%. Between 1999 and 2003, the proportion of male GPs working <6 sessions/week increased from 6.1% to 11.4%, while the proportion working greater than or equal to11 sessions/week fell from 23.8% to 17.1%. Between 1991 and 2003, the proportion of solo practitioners nearly halved (25.5% v 13.7%); the proportion of GPs in practices of greater than or equal to4 partners increased from 34.3% to 59.8%; the proportion of Australian graduates fell from 81.4% to 72.2%; and the proportion of graduates from Asia and Africa increased. Over the same period, the proportion of GPs with Fellowship of the Royal Australian College of General Practitioners more than doubled (17.8% v 36.4%). All of these differences were statistically significant (P < 0.001). Conclusion: Changes in characteristics of the practising GP population will affect consultative services and the balance between supply and demand for these services. These changes should be considered in future workforce planning.