There’s one key reason female GPs like me are quitting

The federal government has announced that 84.1 per cent of visits to general practitioners are now bulk billed, and has called that progress. The figure counts the doctors who’ve stayed in the profession. After 13 years, I am not one of them.

About four years ago, a patient walked into my consulting room struggling – she told me that much. What she could not yet tell me was that she had a specific plan to end her life, and the means to carry it out. She came back recently to tell me that because of the time and kindness of that first appointment, her children have a mother today.

I have thought about that a great deal. Not with pride, but with the weight of it. She was not describing anything exceptional that I did. She was describing what becomes possible when a GP makes enough time to sit with a person. To notice. To make someone feel that they are worth an hour of another human being’s unhurried attention. That is not a luxury. That is general practice.

I am not leaving because I want to. It is the vigilance of never being allowed to miss anything. It is the patient distress carried home. It is the unpaid hours that continue after the last patient has gone. And it is all of that inside a system whose government will not acknowledge, in anything but words, what a good GP is worth. I have been filling the gap between the care I refuse to compromise on and the support I receive to provide it – with my own time, my own earnings, and emotional reserves my children also deserved. I am done.

Female GPs carry a more complex and less remunerated caseload than our male colleagues. In the Royal Australian College of General Practitioners’ 2024 Health of the Nation survey, nearly eight in 10 female GPs named psychological issues among their three most common patient presentations, compared with just over six in 10 male GPs. Women’s health appeared in the top three for 52 per cent of female GPs and 3 per cent of male GPs. Male GPs reported more musculoskeletal, respiratory, circulatory and skin presentations. Complexity takes longer, and it shows: female GPs spend on average three minutes more with every patient. We are also more likely to bulk-bill those who cannot afford to pay, and to run over time because a person needed more than 15 minutes.

Medicare pays per consultation, not per minute. An analysis by Ochre Health of 511 GPs across its practices found the women billed about $24 an hour less than the men – a gap driven almost entirely by the number of appointments fitted into an hour, not by what women charged. We are not paid less for the same work. We are paid less for more complex work that unavoidably requires more time .

The government is telling you that GPs refusing to bulk-bill are the problem. We are not. The problem is an unwillingness to invest meaningfully in general practice, and a determination to disguise that. The “triple bulk-billing incentive” tripled not the bulk-billed rate but a small incentive payment – a pebble thrown into a cavern, with a press release claiming that the cavern was filled and that GPs simply needed to step up.

This is not ignorance.