Estimating non‐billable time in Australian general practice

Abstract

Most GPs spend a significant amount of unpaid time on patient care between consultations, an inherent problem of the fee-for-service system. This work should inform discussions of future funding models.

What matters to people with chronic conditions when accessing care in Australian general practice? A qualitative study of patient, carer, and provider perspectives

“…The popularity of home visits may be in part due to the lack of alternative options to access GPs outside of the traditional format. For example, though mentioned in our study, over-the-phone consultations are a non-billable service and not often done by GPs [33]. While there is some debate surrounding the overall cost and cost-effectiveness of GP home visits, it is clear that they are preferred by patients in the context of having few other options.…”

How do Australian general practitioners spend their time? A cross-sectional analysis of Medicine in Australia: Balancing Employment and Life (MABEL) data examining ‘non-billable workload’

“…7 A substudy of the Bettering the Evaluation and Care of Health (BEACH) program in 2012-14 reported an average of 2.5 hours per week. 5 Woolhandler and Himmelstein's study of US primary care physicians found that 17.3% of their work was 'patient care activities outside of office visits' (termed 'AOVs') and that a higher amount of this work was associated with lower job satisfaction. 14 However, the findings are lower than the estimates reported by several studies that used observational rather than self-reported methods to obtain data.…”

“…This work includes coordinating patient care (eg managing investigation results or liaising with specialists or patients' families) or performing administrative tasks to meet personal and practice management requirements. [3][4][5] In 2017, it was estimated that 20% of Australian GPs' time is spent on this non-face-to-face work; 6 however, previous studies have provided estimates ranging from zero hours to more than nine hours per week. 5,7 Female practitioners report spending more time on these tasks, as do those managing patients who are elderly or have a chronic disease.…”

“…[3][4][5] In 2017, it was estimated that 20% of Australian GPs' time is spent on this non-face-to-face work; 6 however, previous studies have provided estimates ranging from zero hours to more than nine hours per week. 5,7 Female practitioners report spending more time on these tasks, as do those managing patients who are elderly or have a chronic disease. 5 Work outside of the consultation period is non-billable in a fee-forservice context.…”

“…5,7 Female practitioners report spending more time on these tasks, as do those managing patients who are elderly or have a chronic disease. 5 Work outside of the consultation period is non-billable in a fee-forservice context. Clinicians, professional bodies and government advisors have acknowledged the burden of non-billable work.…”