What is in a percentage? (When 60% can be higher than 70%)
Over the past 5 years, I have successfully negotiated contract terms for more than 250 GPs (and unsuccessfully many more).
One of the main sticking points for many General Practitioners is the percentage on offer, with some doctors not even prepared to consider GP Jobs at medical centres offering a lower percentage.
In my experience, this method of assessing the suitability of a potential practice is causing great GPs to miss out on practices that they would have otherwise enjoyed and thrived in.
My advice is always to turn the question around. Rather than asking, ‘what percentage will I receive?’, the question all doctors should ask is;
“As a service provider, what are you providing me for my 30-40% service fee?”
There are lots of variables that affect the income potential for a GP, other than the percentage and it is important to understand these variables and know what questions to ask when you are comparing GP Jobs.
So, what are the most important variables and what questions should you ask?
For each variable, it is important to ask yourself, ‘how much do I value this and what part of my percentage am I prepared to invest’
This is one of the most important factors that can influence how efficient your time is, your earning potential and your enjoyment of the role. Having an experienced team of nurses available every day makes a huge difference to your income, efficiency and enjoyment.
Questions to ask:
- How many registered or enrolled nurses are rostered on each day?
- What is the ratio of nurses to GPs?
- How long have they been with the practice?
- How much medical centre experience do they have?
- Is the Chronic Disease Management Model nurse-led and if so how many nurse-led sessions are available to the GPs within the practice each week?
Practice Management Support
A great Practice Manager is the heartbeat of every practice and can make the difference between an average and high performing medical centre.
Questions to ask:
- How long has the Practice Manager been at the centre?
- What is their experience working in primary care?
It is often common for a struggling practice to offer a higher percentage, with up to 85% being offered in extreme examples. It is therefore important to get a clear understanding of the patient demand and understanding of why this position has become available, particularly if GPs have been leaving the practice recently.
Questions to ask:
- How many spare appointments have there been on average over the past 3 months
- Why did the position become available?
- Are some GPs in the practice busier than others and if so why? e.g. are they offering different specialty services like skin clinics etc.
- If any GPs have left the practice recently what were the reasons they gave?
Always ensure that you have spoken to at least one of the GPs at the practice before accepting a role. If they are keen to speak to you and encourage you to join, it is a good indicator that there is more than enough work to go around.
Mixed (or Private) billing vs Bulk Billing
Quite simply, there is no simple answer here, as there are a lot of variables that need to be taken into consideration. But, when assessing your options, it is likely that a well-established mixed/private billing centre will offer greater income potential than that of a bulk billing centre if other variables are similar.
65% or even 60% of a mixed/private practice may well generate higher income than 70% at a bulk-billing practice. As mentioned earlier, another consideration at this point is to ascertain whether the CDM model is nurse or GP lead as this can make a big difference to the number of patients seen during the day and therefore income levels.
A lot of the major service providers monitor the $ per consult of their GPs, as this is often a good indicator of how well a new GP is performing in comparison to more experienced GPs within the practice and highlights any potential retention issues. Simply, it is weekly billings divided by weekly patient numbers to give the average $ per consult.
This amount can significantly vary from practice to practice, with GPs in predominantly bulk billing centres averaging a significantly lower $per consult than those in private billing centres.
The reality being, that the bulk-billing GPs must either spend less time with their patients, have access to nurse led CDM clinics or work longer hours to achieve the same financial outcome as their peers in more predominantly private billing centres.
Questions to ask:
- What is the billing policy of the practice?
- What percentage of the patients are private billed?
- Do all doctors at the practice observe the same policy?
- Can GPs at the practice influence the % of mixed or private billing?
- How long has the practice been mixed or private billing?
- Can you bring to the practice any areas of special interest that differ to the other GPs in the practice?
Like a lot of things in life these days, quality carries a higher cost. If you want a high quality product or service, then you know this is going to cost a little more.
By changing the percentage question around and ensuring you truly understand the billing policy, nursing/practice support and patient demand, you can maximise the chances of making the right decision and the right practice for you. One that balances income potential, work-life balance and personal and professional satisfaction.
AND FINALLY…………always observe the ‘Golden Rule’ and speak to at least one of the GPs onsite before accepting a position.
For more information about anything covered in this blog, please contact Darren to discuss your specific situation.
Darren Compton (B.Sc. Hons)
m: 0405 234 852