Monash University
Ethics Approval Number:
DEVELOPING AND
EVALUATING VIABLE
ORGANISATIONAL
AND ECONOMIC
MODELS OF RURAL
GENERAL PRACTICE
Commonwealth Government Statistical
Clearing House Approval Number
DEVELOPING AND EVALUATING VIABLE RGANISATIONAL
AND ECONOMIC MODELS OF RURAL GENERAL PRACTICE
The purpose of this survey is to collect information about the content,
complexity, context and costs of general practice in different rural and remote
environments.
This project, sponsored by the Department of Health and Ageing and auspiced by the
Rural Doctors Association of Australia in association with Monash University
Bendigo, represents the first step towards ensuring practices remain viable and able to
provide rural communities with the medical service they need
We are surveying all general practitioners throughout rural and remote Australia. All
information will remain entirely confidential, and your participation in this survey is
entirely voluntary. It will not be possible to identify any individual responses in
reports of the results of this survey.
Instructions for completing this Questionnaire


Please use a black or blue pen to complete this questionnaire.
Most questions may be answered by placing a tick in the appropriate answer
box.
 For some questions, more than one answer option may be selected, for
example:
Tick all that apply
Under school age

Attending Primary school

Attending Secondary school

Some questions will be answered by placing numbers or text in the answer
box, for example:
MYTOWN
Town/locality name
8 7 6
postcode
5
Section 1 – Demography
The following questions provide essential information required to profile the
characteristics of rural general practitioners (GPs) and their practices.
1
What is the name of the practice in which you work? (Business or
trading name)
2
2
What is the name and postcode of the town or locality where your
main practice is located?
Town/locality name
3
postcode
What is your business relationship to the practice named in Question 1?
 Note: 'Contracted employee' includes contracts incorporating a percentage of billings
Tick one box
Principal or partner
Associate
Salaried employee
Contracted employee
GP Registrar
Locum
Other
4
What is your main practice type?
Tick one box
A solo private practice
A group private practice
Medical superintendent/officer with rights to private
practice (Queensland only)
Go to Question 6
A full-time position in a public facility such as a
Community Health Centre or public hospital.
Go to Question 6
A practice in an Aboriginal Community Controlled
Health Service
Go To Question 6
Locum work
Go To Question 6
Other (Please specify)
Go To Question 6
……………………………………………………………..….
3
5
Do you have Visiting Medical Officer (VMO) rights at a local hospital
for either of the following?
(a) Private patients only
No
Yes
(b) Public and private patients
No
Yes
6
What is your age in years?
7
What is your sex?
Male
Female
8
Do you have a spouse or partner who is a rural doctor?
No
Yes
9
Do you have any children in the following categories?
Note
 Primary/Secondary school includes day school, boarding school, School of the Air,
Correspondence School and Home Schooling.
 A Tertiary Educational Institution includes on-campus and Distance Education modes
Tick all that apply
Under school age
Attending Primary school
Attending Secondary school
Attending a Tertiary Educational Institution
4
10
Under which of the following Provider Number arrangements are you
currently practising?
Tick one box
Australian trained, no location restrictions on access to
Medicare benefits
Australian trained, temporary Provider Number for rural
location
GP trainee at an approved training placement
Temporary resident - Medicare access location restricted
Temporary resident - Medicare access unrestricted
Overseas trained permanent resident/Australian citizen Medicare access location restricted
Overseas trained permanent resident/Australian citizen Medicare access unrestricted
11
How long have you been in your current practice?
Tick one box
Less than 1 year
From 1 to less than 2 years
From 2 to less than 3 years
From 3 to less than 5 years
From 5 to less than 10 years
Ten or more years
12
How much longer do you intend to stay in your current practice?
Tick one box
Less than 1 year
From 1 to less than 2 years
From 2 to less than 3 years
From 3 to less than 5 years
From 5 to less than 10 years.
Ten or more years
Undecided
5
13
How many general practitioners are there in:
Note

Please include yourself

Please indicate the number of practitioners, regardless of whether full or part time
(a) your practice?
(b) your town?
14
How many general practices are there in your town?
Note: Please include your own practice
Tick one box
One
Two
Three to Five
Six to 10
Eleven to 20
More than 20
15
Does your practice operate any branch surgeries?
No
Yes
Section 2 – Nature and complexity of general practice activity
This section seeks information about the type and range of activities that you
currently undertake in your capacity as a GP.
16
Estimate the total number of consultations you provide in both your
practice and hospital in an average working week.
Include

Face to face consultations

Procedures

Telephone consultations.
Consultations
(a) Number of consultations in your practice
(b) Number of consultations in hospital
17
Estimate the total number of MBS (Medicare
eligible) consultations you provide in an
average working week
6
MBS
consultations
18
Estimate the total hours worked by you in an average working week, in
each of the practice setting, the hospital setting and in other settings.
Note: Pro rata hours for regular commitments undertaken less than weekly.
Include
 Remunerated and non-remunerated
medical and professional activities
 Continuing medical education
Exclude
 After-hours on-call time not worked
 Hours worked in any non-medical
capacity, eg in other business interests
Hours
(a) In the practice setting
(b) In the hospital setting
(c) In other settings (eg nursing home, Division)
19
Estimate the total hours worked by you in patient-related activities in an
average working week.
Patient-related activities include

Consultations and procedures

Other services such as dispensing, radiology and ultrasound

Indirect patient care such as documentation, case notes, case conferencing, discharge
planning

Travel to and from patient visits
Hours
Hours in patient-related activities
20
For the hours reported in Question 19, please provide a breakdown by
remunerated and non-remunerated activities.
Note

If you are a salaried employee, all patient-related activities should be classed as
remunerated
Hours
(a) Remunerated patient-related activities
(b) Non-remunerated patient-related activities
21
Estimate the total hours worked by you in non-patient-related activities
in an average working week.
Non-patient-related activities include

Administration

Medico-legal work

Teaching/education/student supervision

Continuing Medical Education and research

Professional activities including Division, College, professional associations,
professional committees

Non-patient-related travel for professional activities
Hours
Hours in non-patient-related activities
7
22
For the hours reported in Question 21, please provide a breakdown by
remunerated and non-remunerated activities.
Note

If you are a salaried employee, non-remunerated non-patient-related activities may be
limited to professional activities through the Division, College or a medical
association and related travel.
Hours
(a) Remunerated non-patient-related activities
(b) Non-remunerated non-patient-related activities
23
Please indicate which of the following procedures you currently practise.
Tick all that apply
Accident & Emergency (emergency medicine) at a
hospital or emergency centre external to your main clinic
Obstetrics
General Anaesthesia
Minor Surgery (under local anaesthesia)
Major Surgery (under general anaesthesia)
Other (please specify)
………………………………………………………….…
24
Please indicate which of the following you currently do in treating
myocardial infarction.
Tick all that apply
Initiate emergency treatment
Continue beyond emergency treatment including
administration of streptokinase if indicated
Manage as in-patient
25
Do you ever administer systemic cytotoxic drugs?
No
Yes
26
In the last three years, have you performed a forensic examination on a
sexual assault victim at the request of the Police?
No
Yes
8
27
How often do you coordinate discharge management (discharge
planning) of patients from hospital?
Tick one box
Never
Less than once a week
One to five times a week
Six to 10 times a week
Eleven to 15 times a week
More than 15 times a week
28
Are you routinely involved in the stabilisation of injured patients
pending retrieval or evacuation?
No
Yes
29
How far is it from your practice to the nearest hospital or health facility
with in-patient care?
Tick one box
Less than 10 kms
10 to 49 kms
50 to 99 kms
100 to 199 kms
200 to 499 kms
500 kms or more
30
By which of the following medical practitioners is your local hospital
staffed?
Tick all that apply
Yourself only
Self and other GPs
GPs other than yourself
Resident Medical staff
Specialists
9
31
How far is it from your practice to the nearest health facility that
provides 24-hour caesarean section capability?
Tick one box
Less than 10 kms
10 to 49 kms
50 to 99 kms
100 to 199 kms
200 to 499 kms
500 kms or more
32
During your last day of consultations in your practice rooms, how many times
were consultations interrupted by telephone calls from other health
professionals seeking urgent advice?
Include calls from
 Hospital staff
 Allied health professionals
 Nurses
 Doctors
Exclude
 Non-urgent calls
 Interruptions other than telephone calls
Tick one box
No telephone interruptions during any consultations
One interruption during the whole day
Two or three interruptions
Four to six interruptions
Seven to10 interruptions
More than 10 interruptions
33
During your last day of consultations in your practice rooms, were you called
out to physically attend another patient (e.g. emergency or delivery) elsewhere,
other than in the consulting rooms?
No
Yes
34
Do you work any after-hours on-call?
Go to Question 38
No
Yes
10
35
What is your after-hours on-call ratio for hospital and practice work?
Note: for example, 6 nights per fortnight equals 1 night in 2.3 (14/6)
(a) For hospital work
One night in
One weekend in
(b) For practice work
One night in
One weekend in
36
How many hours last week were you rostered
or listed for after-hours on-call?
Hours
37
How many hours last week did you work
during after-hours on-call time?
Hours
38
How many days recreation leave have you taken
in the last 12 months?
Days
39
How many days have you taken out of your
practice for Continuing Medical Education in
the last 12 months?
Days
How many days have you taken out of your
practice to care for a family member
in the last 12 months?
Days
40
Section 3 – Cost indicators associated with carrying out
general practice activities
This section seeks information relating to some of the costs associated with
general practice.
41
Do you regularly make long distance calls to consultants or tertiary hospitals
about the care of your patients?
Go to Question 43
No
Yes
11
42
Please give details about the calls described
in Question 41, for an average working week.
Calls per average
working week
(a) How many calls are about patients who
have already seen the consultant?
(b) How many calls are about patients who are
unlikely to see the consultant?
(c) How many calls are about patients who are
likely to be referred?
43
Do you ever employ locums?
Go to Question 45
No
Yes
44
Where do you usually house locums?
Tick one box
Own house
Rented house
Hospital facility
Motel/hotel
Other accommodation
45
What is the fee per week for non-subsidised
locums for your practice?
46
What is the fee per week for subsidised locums for
your practice?
$
Note
That is, the amount you/your practice pays to the work force agency/health department for
the locum
$
Fee per week
47
Do you teach medical students or GP Registrars in your practice?
Go to Question 49
No
Yes
48
Would you consider increasing the number of student or Registrar
placements?
No
Go to Question 50
Yes
Go to Question 50
12
49
What is the main reason that you/your practice does not teach medical
students or Registrars?
Tick one box
Not interested
No dedicated room
No time
Not economic
Accommodation not available
Registrar not available
Too much paperwork required
Other reason
50
Of the normal consulting hours for your practice, on average how much
time per week are the rooms open when there is no GP present?
Include
 Times when you or other GPs in your
practice would normally be consulting in
the rooms, but are called out to attend a
patient away from the rooms, attend an
emergency or delivery, etc. and there is
no GP left in attendance at the practice.
Exclude
 Time when a locum is attending the
practice in place of an absent GP
 Time on leave when leave cover has been
arranged
Hours
Average hours per week
51
52
What road distance did you travel in the
2000/2001 financial year in the course of
providing medical care services?
Kms
Are your vehicle costs subsidised?
No
Yes
$
53
What is your annual medical indemnity
premium?
54
Is your medical indemnity premium subsidised in some way?
Note
For example, subsidised by the state government, or your employer
Go to Question 56
No
Yes
13
55
How important is this subsidy in ensuring that you will continue
procedural practice?
Tick one box
Not a proceduralist
Strongly ensures continued procedural practice
May ensure continued procedural practice
Insufficient to ensure continued procedural practice
Section 4 - Measures required to improve the viability of
general practice in your community
This section seeks your opinions on what measures (including the commercial
aspects) would be most beneficial to bring about improvements in workforce
supply and the viability of your current practice.
56
Thinking about what would help most to attract more GPs to this
community, please rank the following factors from 1 to 6 in order of their
importance
Note
Rank the 6 items from 1 to 6, where 1 = most important and 6 = least important.
Rank
Better education and professional support activity
Better locum availability
Better remuneration per Medicare consultation
Capital funding to improve your practice infrastructure
or to enable GPs to set up practice
Improved after-hours and on-call arrangements
Improved availability of allied health professional
services
57
Thinking about what would help most to retain GPs in this community,
please rank the following factors from 1 to 6 in order of their importance.
Note
Rank the 6 items from 1 to 6, where 1 = most important and 6 = least important.
Rank
Better education and professional support activity
Better locum availability
Better remuneration per Medicare consultation
Capital funding to improve your practice infrastructure
or to enable GPs to set up practice
Improved after-hours and on-call arrangements
Improved availability of allied health professional
services
14
58
Thinking about options for increasing your practice income, please rank
the following factors from 1 to 6 in order of importance
Note
Rank the 6 items from 1 to 6, where 1 = most important and 6 = least important.
Rank
Additional partners or associate doctors in the practice
An increase in allied health and nursing support
An increase in Medicare rebates
An increase in patient fees
Guaranteed minimum income
Specific rural consultation item numbers
59
Thinking about options for reducing costs in your practice, please rank
the following factors from 1 to 5 in order of importance
Note
Rank the 6 items from 1 to 5, where 1 = most important and 5 = least important.
Rank
Reduce costs by improving practice efficiencies
Reduce non-remunerated work load
Subsidised housing
Subsidised practice costs such as locums, travel,
telephone, etc
Subsidised practice premises and facilities
60
In your opinion, does this practice have enough doctors to ensure a
reasonable workload and time off and to maintain practice viability?
No
Go to Question 62
Yes
Full-time
doctors
61
How many additional full-time doctors are
required in this practice?
62
In your opinion, does this community have enough doctors to service the
health and medical needs of its residents?
No
Go to Question 64
Yes
63
How many additional full-time doctors are
required in this community?
15
Full-time
doctors
64
What would be the net effect on your income of recruiting additional
GPs to this practice?
Tick one box
A net increase in your income
Income-neutral for you
A net decrease in your income
Don't know/not sure
65
What are the key factors contributing to the viability of your practice?
………………………………………………………………………………………..
………………………………………………………………………………………..
………………………………………………………………………………………..
………………………………………………………………………………………..
66
What factors would put the viability of your practice at risk?
………………………………………………………………………………………..
………………………………………………………………………………………..
………………………………………………………………………………………..
………………………………………………………………………………………..
16
Section 5 - Income and Expenses
This section seeks information relating specifically to the commercial aspects
of rural general practice.
As with all questions in this survey, all information collected
in this Section will be entirely confidential.
67
If you are a salaried or contract GP:
What was the total value of your salary/contract package from your
current medical practice, for the financial year 2000-2001?
Note

Show before-tax income

If employed for less than the full financial year, please indicate the number of months
employed.
Include
 Employer contribution to superannuation
 Your income from a percentage of billings
 Value of any other benefits in the package
(a) Total value of salary/contract
package
Exclude
 Income from any business or activity
other than that related to work for the
practice named in Question 1
$
(b) If you were employed for less than the full
2000-2001 financial year in current practice,
please indicate number of months
Please go to Question 70
17
Months
68
If you are a principal, partner or associate:
What was the total income for this practice, for the financial year 20002001?
Note

Show before-tax income

If in operation for less than the full financial year, please indicate the number of
months in operation.
Include
 Medicare and patient payments
 Third party insurance payments, Veterans
Affairs payments
 Incentive payments, other grants and fees
(a) Total practice income
Exclude
 Income from any business or activity
other than that related to the practice
named in Question 1
$
(b) If practice in operation for less than full 20002001 financial year, please indicate number of
months
69
If you are a principal, partner or associate :
What was the total cost of operating this practice, for the financial year
2000-2001?
Include
 Salary, wages and contracted services
costs
 Insurance, depreciation, rent, maintenance,
utilities and other costs
Total practice operating costs
70
Months
Exclude
 Distributions to partners or principals
$
Please estimate the time taken to complete this
Questionnaire
Minutes
Thank you for completing this Questionnaire
Please return completed Questionnaire in the envelope provided,
or mail to:
Health Connections Pty Ltd
Reply Paid 009
Sheridan Street
GUNDAGAI NSW 2722
18