Addendum to the GPRA Terms & Conditions Benchmarking Survey Background In May 2010 GPRA conducted a survey amongst registrars across Australia in order to explore Registrar opinion regarding GPET’s draft Training Time Policy, released in April 2010. GPRA took this opportunity to further clarify questions which were raised by their 2010 Terms and Conditions Benchmarking Survey (conducted between October 2009 and January 2010), about the terms and conditions that registrars are paid during their training, especially in relation to average earnings, on call and after hours work. The results from this survey are available in a document titled GPRA's Terms and Conditions Benchmarking Survey Report 2010. This report forms an addendum to that report. Methodology Registrars were invited to complete an online survey via Registrar Liaison Officers, the GPRA eNewsletter and a direct email to GPRA members. A total of 382 registrars took part in the survey between the 11th and 27th May 2010. Summary of Key Findings • Average gross weekly earnings for a Full‐Time registrar in the AGPT program is $2,389; excludes overtime or on call work • Average gross weekly earnings for a Part‐Time registrar in the AGPT program is $1,452; excludes overtime or on call work • 55% is the most common percentage earned for on‐call work for the Practice (21% of respondents) o Most registrars (63% of respondents) appear to earn a percentage between 45% and 65% • 70% is the most common percentage earned for on‐call work for the Hospital (19% of respondents), if any; this is followed by 55% (12% of respondents) o One in five registrars (20% of respondents) who do on call work for a hospital are paid a flat rate or fixed call in fee for this work
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Demographics Registrars from all RTPs were represented in the survey sample. As shown in Table 1, registrars from the RTPs CSQTC and CCCT were somewhat over‐represented in the sample (16% and 12% respectively). Table 1: Regional Training Provider Regional Training Provider % n Adelaide to Outback General Practice Training Program (AOGP) 3.4% 13 Beyond Medical Education (BME) 2.1% 8 Bogong Regional Training Network (Bogong) 5.2% 20 Central & Southern Queensland Training Consortium (CSQTC) 15.7% 60 CoastCityCountry Training (CCCT) 11.5% 44 General Practice Training Tasmania (GPTT) 7.3% 28 General Practice Training Valley to Coast (GPTVTC) 7.9% 30 Gippsland Education & Training for General Practice (getGP) 4.2% 16 GP Synergy 4.5% 17 Greater Green Triangle General Practice Training & Education (GGT) 3.1% 12 North Coast GP Training (NCGPT) 2.6% 10 Northern Territory General Practice Education (NTGPE) 3.1% 12 Queensland Rural Medical Education (QRME) 0.5% 2 Remote Vocational Training Scheme (RVTS) 0.5% 2 Sturt Fleurieu General Practice Education & Training 5.5% 21 Tropical Medical Training (TMT) 7.6% 29 Victorian Metropolitan Alliance (VMA) 6.5% 25 WentWest 2.9% 11 Western Australian General Practice Education & Training (WAGPET) 5.8% 22 Total 382 Base: All Respondents (n=382)
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Table 2: Current training Training workload Full‐time Part‐time Currently on leave/Other Term currently In GPT1 GPT2 GPT3 Extended skills Hospital term Other
% 71.5% 23.0% 5.5% % 30.6% 8.6% 28.8% 13.1% 10.5% 8.4%
n 273 88 21 n 117 33 110 50 40 32
Base: All Respondents (n=382)
Close to three‐quarters of the respondents (72%) were full‐time registrars, with just under a quarter being part‐ time registrars (23%); this approximates the ratio of full‐time to part‐time registrars enrolled in the AGPT program. There were fewer GPT2 registrars in the sample (9%), explained by the timing of the survey within the training year, however a good spread of representation was still achieved by training term. Table 3 shows that GPT1 and GPT3 registrars made up 62% of the full‐time registrar sample whilst there was more of a spread in terms of stage of training part‐time registrars’ in the sample were in. Table 3: Training workload by term currently in
% of Respondents GPT1 GPT2 GPT3 Extended skills Hospital term Other No. of Responses
Currently on leave/Other
30.6% 8.6% 28.8% 13.1% 10.5% 8.4% 382
35.2% 6.2% 27.1% 12.8% 12.1% 6.6% 273
17.0% 17.0% 37.5% 14.8% 4.5% 9.1% 88
28.6% 4.8% 14.3% 9.5% 14.3% 28.6% 21*
*Note: Small Sample Size (n=<30), interpret with caution
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Average Earnings Each Week for Ordinary Hours in General Practice Respondents were asked to estimate how much they earned for ordinary hours in General Practice, exclusive of overtime and on‐call work. Average earnings per week for full‐time registrars and for part‐time registrars are shown by GP Term in Tables 4 and 5 respectively. The results suggest in general that earnings do increase steadily as registrars’ progress through their training, however results should be treated as indicative only given the small sample sizes achieved for some segments at the term level. Table 4: Average earnings for Full‐Time registrars ‐ Amount earned each week for ordinary hours in general practice, excluding overtime and/or on‐call GP Term Extended Total Full‐time Hospital Skills/ Special respondents Term GPT1 GPT2 GPT3 Skills Other Average $2,389 $1,412 $2,134 $2,836 $2,631 $2,420 $3,364 Maximum $6,000 $4,000 $6,000 $5,000 $6,000 $5,000 $5,200 Minimum $320 $320 $700 $1,500 $600 $1,000 $1,770 Standard $1,182 $883 $1,114 $1,048 $1,203 $1,039 $1,172 Deviation No. of 219 13* 89 16* 66 23* 12* Responses Q11. Estimate how much you earn each week for ordinary hours in general practice EXCLUSIVE of overtime or on call? Please enter gross weekly earnings (i.e. before tax is taken out) Base: Full‐Time Respondents (n=219; n=49 did not answer this question and n=5 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution.
Table 5: Average earnings for Part‐Time registrars ‐ Amount earned each week for ordinary hours in general practice, excluding overtime and/or on‐call GP Term Extended Total Part‐time Hospital Skills/ Special respondents Term GPT1 GPT2 GPT3 Skills Other Average $1,452 n/a $1,331 $1,150 $1,542 $1,833 $1,330 Maximum $4,000 n/a $4,000 $3,000 $3,500 $3,000 $2,750 Minimum $150 n/a $450 $500 $850 $150 $700 Standard $755 n/a $1,061 $679 $547 $907 $814 Deviation No. of 69 1 ($600) 12* 11* 31 9* 5* Responses Q11. Estimate how much you earn each week for ordinary hours in general practice EXCLUSIVE of overtime or on call? Please enter gross weekly earnings (i.e. before tax is taken out) Base: Part‐Time Respondents (n=69; n=19 did not answer this question) *Note: Small Sample Size (n=<30), interpret with caution
In addition to weekly earnings, the training time survey also collected data on the number of hours registrars have scheduled as direct patient contact time per week.
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The average number of hours scheduled as direct patient contact time is presented alongside weekly earnings for full‐time and part‐time registrars in table 6. With full‐time registrars earning an average $2,389 per week and having an average 33.3 hours/week scheduled as direct patient contact time suggests that full‐time registrars earn an average $71.74 per hour of patient contact time; at $75.63, the average hourly rate for part‐time registrars appears to be somewhat higher. It must be noted however that other work such as administration time and teaching time would usually form part of a registrar’s “Ordinary Hours” therefore the actual hourly rate would be less for most registrars. Table 6: Average earnings for ordinary hours in general practice & Average direct patient contact time per week Total Full‐Time Part‐Time $ Hrs/week $ Hrs/week Average $2,165 $2,389 33.3 $1,452 19.2 Maximum $6,000 $6,000 50 $4,000 38 Minimum $150 $320 15 $150 9 Standard $1,165 $1,182 5.1 $755 6.3 Deviation No. of 288 219 233 69 84 Responses Q11. Estimate how much you earn each week for ordinary hours in general practice EXCLUSIVE of overtime or on call? Please enter gross weekly earnings (i.e. before tax is taken out) Base: All Respondents (n=288; n=68 did not answer this question and n=5 outliers were removed) *Note: Small Sample Size (n=<30), interpret with caution. Note: The results shown in the columns ‘Hrs/week’ are the average number of hours registrars have scheduled as direct patient contact time per week (Q4. In your general practice post, how many hours do you have scheduled as direct patient contact time (i.e. consulting time) per week?)
Earnings for On‐Call Work Respondents were also asked about what percentage of earnings they are paid for any on‐call work they do for their practice. The reader should note that a total of 256 respondents who started the survey (being n=382) either did not answer this question or indicated it was not applicable to them. Amongst those who did some on‐call work for their practice, the percentage earned varied considerably across this sample (as shown in Table 7), although the most common percentage was 55% (21% of respondents) with most registrars earning a percentage between 45% and 65% (63% of respondents). A relatively small proportion of respondents (4%), were on a flat rate or received a fixed call in fee for practice on‐call work.
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Table 7: Percentage of earnings paid for on‐call work do for Practice % of Respondents <45% 45% 50% 55% 60% 65% 70% 75% 80% 85% >85% I am paid a flat rate or fixed call in fee Other No. of Responses
4% 13% 9% 21% 12% 8% 5% 6% 2% 1% 11% 4%
5 17 11 27 15 10 6 7 3 1 14 5
Q14. If you do on‐call work for your practice, what percentage of earnings are you paid? Please select the closest percentage *Note: Small Sample Size (n=<30), results to be treated as indicative only. Base: All Respondents (n=126; n=143 did not answer this question and n=113 indicated that this question was not applicable to them and so were removed from the results)
Respondents were asked to indicate what percentage of earnings they are paid for on‐call work they do for a hospital, if any. A total of 281 respondents who started the survey (being n=382) either did not answer this question or indicated it was not applicable to them. Amongst those who do some on‐call work for a hospital the most common percentage earned for this work was 70% (19% of respondents) followed by 55% (12% of respondents). There was however a wide range of responses, with some registrars earning less than 45% (3% of respondents) and 11% earning greater than 85%. As high as 20% of respondents indicated that they do not get paid a percentage for on‐call hospital work, but rather a flat rate or fixed call‐in fee.
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Table 8: Percentage of earnings paid for on‐call work do for Hospital % of Respondents <45% 45% 50% 55% 60% 65% 70% 75% 80% 85% >85% I am paid a flat rate or fixed call in fee Other No. of Responses
3% 5% 5% 12% 9% 3% 19% 5% 4% 1% 11% 20%
3 5 5 11 8 3 18 5 4 1 10 19
Q13. If you do work on‐call for a hospital, what percentage of earnings are you paid? Please select the closest percentage *Note: Small Sample Size (n=<30), results to be treated as indicative only. Base: All Respondents (n=94; n=157 did not answer this question and n=124 indicated that this question was not applicable to them and so were removed from the results; the responses of n=7 respondents who were in hospital term were also removed from the calculation of this result)
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Additional Comments Respondents were asked to provide any further comments they may have had at the end of the survey (at Q15) for GPRA’s consideration. A number of responses were received (n=55) with the following being a sample of some the comments made which related to what registrars earn; • “...The hospital allocates 38hours of in hour’s time to the practice to be divided by the GPs. I get 1 hour of this and the rest is split amongst my 4 supervisors. This definitely doesn't represent my fare share of the work load and I would like to know what other DHHS sites and registrars get paid of these regular hours. I get 100% of my out of hours call back rates for the hospital” – GPT1 Registrar • “I have a couple of points to make about my pay and conditions. One is that I earned a lot more in the hospital system before I moved into my GPT1 term. This was mainly because of penalty rates, rather than overtime. I am willing to sacrifice quite a bit of pay in order to have the more civilised hours of general practice, but it is still a disincentive to enter general practice nonetheless and I wondered if this income drop could be mentioned during NMT&C negotiations with the supervisors' association. Also, I was expected to negotiate with my first practice on pay and conditions (i.e. perhaps to achieve something better than the national minimum) but in reality, I was not really in a position to negotiate and I doubt that I will ever do that in my advanced or subsequent terms. Even if I had felt bold enough to negotiate, I didn't have any information on average billing percentages etc that other registrars were receiving. This is valuable information that registrars would love to have access to.” – GPT1 Registrar • “I feel underpaid at present, earning 50% in final year no ability to negotiate as practice is outer metro and I need them more than they need me.” – GPT3 Registrar • “I am not paid anything for taking the on‐call phone, which only functions for an on‐call purpose from 5am‐8am daily.” – GPT2 Registrar • “What a (disappointing) difference coming from the public hospital system... now I am a registrar supporting my family and get paid much less, work more hours than what I am (in reality) paid for, get paid relatively poorly for working on call (55% of billings) and cannot salary package. In addition I get no education allowance, as my Vic public hospital colleagues do, and cannot afford to take off as much time as I would like to breastfeed my second child when it will be born later this year as I get no paid parental leave (and am the income earner for the family). My clinic bulk bills 70% of patients which puts me much further behind many of my colleagues whose practices privately bill many patients.” – GPT1 Registrar • “I get paid 45% billings plus hourly base wage for release days/sessions. Other registrars I know get nothing for release days if their billings on the days they work exceed their FTE base wage, which in essence means they are not being paid at all for release days. Some registrars when they start out are unaware of the negotiation of base versus percentage and are "stuck" with base wage in their Term 1. The financial difference can be significant!” – GPT1 Registrar • “After hours on call I am paid 100% of earnings. Other times I earn 65% (inc super) which is the same as I am paid in the clinic.” – GPT3 Registrar
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“I think there should be more specific provisions for minimum conditions in the subsequent term. e.g. minimum 50% + leave. It is all a bit vague for subsequent term registrars and I think some supervisors take advantage of this fact knowing that registrars are sometimes not in a position to negotiate (e.g. when there are only very limited options for completing rural term requirements). This has been my current situation ‐ I am (I believe) a competent subsequent term registrar and have passed all my exams and received consistently positive feedback; and yet I am only being paid 45% (+ leave and super as per minimum terms and conditions). I would also be interested to know how the GPRA is going to tackle the issue of the loss of specific nurse MBS item numbers (e.g. 10993 and 10996) once the new nurse payment system is implemented. This will have a significant impact on registrars and other contractors who are only paid a % of their gross billings.” – GPT3 Registrar “If it is in‐hour on call, we got pay only the base rate 45%. if it on weekend, the rate is 55%. We don't get pay for on call, so we earn less money when we are on call. if we are called to see the pt in hospital during working hour, we only can see 1 pt every 45‐60 min, while in clinic we may see 4 patients. And we only get pay 45% for the pt we see in hospital during working hour.” – GPT1 Registrar “Pay for hospital work at our practice is based on "after hours" or "in hours" rates; "In hours" (i.e. taking you away from the practice) paid 58%, "after hours" (i.e. outside standard working hours) paid at 70%.” – GPT3 Registrar “The issue is that with being in a hospital the additional on call per week with the hospital is not counted as GP work by the RTP this means I usually do about 45‐50 hours a week (as cover for the hospital as part of my term, but am only classed as working 28 (as this is face to face GP contact).” – GPT3 Registrar “I have been down to do on call at the hospital and have admitting rights but I get paid nothing at all for doing that ... so one soon doesn't bother too much doing the extra hours.” – GPT3 Registrar “I believe GPRs are a weak party in negotiating terms and conditions because often your supervisor is your boss. For GPR Term1 and 2, some policy should be made universal, like group negotiation in corporates. 1. Payment review periods: we get paid whichever is higher between percentage and minimum flat rate. Some supervisors reconcile every two weeks, or two fortnightly, or even three monthly. Mathematically it does affect your payment; 2. Minimum pay rate: All GPR are at least PGY3, and because GPRs get paid by percentage, so they do not get paid if they take sick leave, annual leave, whereas hospital SRMO/Registrars do. So the pay rate should at least match them. Simply because GPRs get less supervision in GP than hospital setting. 3. Some country GP surgeries are owned by council and therefore are bulkbilling which is really good for patient and understandable. But most of country practices charge nearly 50% more than bulk billing. So the percentage should then be adjusted, not only 45 % for Term 1/2. When bulk billing and same percentage, country GPRs get same pay as Sydney GPRs, which does not make sense.” – GPT1 Registrar
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Published on Nov 10, 2010
This brief report forms an addendum to the GPRA 2010 Terms and ConditionsBenchmarking Survey (conducted between October 2009 and January 201...