More than a third of older GPs bringing forward retirement plans thanks to CPD, survey suggests—but Medical Board claims otherwise…

Onerous CPD requirements are causing many GPs to consider an early exit from clinical practice, with 45% decreasing engagement because of the new system, according to a Healthed survey of around 1500 GPs last month.

About one quarter of surveyed GPs said they intend to retire earlier (26%)—and this was much more common among older doctors.

Specifically, 37% of those aged 55 and over intend to bring forward retirement plans, compared to just 8% of younger GPs. One fifth of GPs who were ≥55 said they plan to leave general practice, compared with 10% of those under 55.

Australian Doctors Federation chair Dr Aniello Iannuzzi said the requirements are not only excessive, but also counter-productive, with no proof they’ll lead to improved outcomes, and a high chance of an exodus among the older cohort, which he said happened when CPD first became mandatory, and will happen again.

“All of these categories are just going to encourage yet another new bureaucracy, yet another new credentialing industry, yet more gaming of the system, and it’s causing that much destruction that doctors are exiting the system—and we can ill afford that,” he said.

“I don’t think there’s going to be any way of measuring outcomes for the success of this programme or not — 50 hours a year is very onerous, very expensive. So if you’re part time, the business case for this is crazy,” he added.

Many GPs in Healthed’s survey sounded despondent.

“I’m depressed because I doubt I can get all this stuff completed every year. What a nightmare on top of hugely busy weeks. I suppose I will just have to deregister at the end of the year. The three-year cycle was more manageable,” one GP wrote.

“It hangs over me like an oppressive weight. I worry about how to achieve the measuring outcomes points,” another GP said. “I miss social events now frequently to do webinars. I am seriously thinking of retiring at the end of this year totally due to the new CPD requirements. I am very happy to do many hours of education, but I think the measuring outcomes is just too hard and achieves nothing.”

The Medical Board’s response

However, a spokesperson for the Medical Board downplayed the concerns. When asked to comment on Healthed’s quantitative survey results, they said the changes “bring more flexibility and more value to GPs.”

“We’re not talking about 50 new hours of CPD, because under the changes, GPs are able to count a lot of the things they already do every day at work towards their CPD,” the Medical Board spokesperson told Healthed. “Clinically relevant corridor chats, practice/team meetings, practice management, case conferences, teaching/supervision, incident reporting and professional reading are all legitimate CPD activities. No longer is CPD restricted to accredited activities.”

“There is a lot of pressure on GPs, but we’re not convinced that our CPD changes feature on the list of reasons why doctors might be contemplating a future outside medicine. A lot of these pressures – income squeeze, Medicare rebates, patient demand, distribution of GPs, etc – are issues for governments. In terms of workforce, the Board has a big focus on issues related to IMGs, to strengthen their vital role in Australia’s health workforce.”

Healthed’s survey suggests otherwise. About half of GPs who work 30 hours or less said they intend to reduce their involvement in general practice due to the new CPD. Overall, 28% of surveyed GPs said they were seeking out ways to reduce CPD related stress and burnout, and in an earlier survey in June, two thirds said the requirements had worsened their stress levels.

“I’m hearing such negative feedback and in fact, I can honestly say I haven’t heard one doctor speak well of it. They all see it as just bureaucratic overreach,” Dr Iannuzzi said.

As for how to improve things, he reckons making it optional would be a good start. Beyond that, he says the focus should be on keeping up to date with technology, pharmacology, best practice etc. “Things are changing at such a rapid pace. Educational activities are what should be prioritised. Not looking at your belly button thinking, you know how I do feel about myself as a doctor today”

What GPs in Healthed’s survey are saying

“I used to enjoy reading and attending things that interested me. Now it’s such a drudge trying to match and find activities to fit into a learning plan. As for taking a week off work, unpaid, to meet the requirements—well you can only imagine how I feel about that… I doubt I’ll be registered by the end of the year despite needing to continue working. The three yearly cycle was more manageable.”

“If I could walk away from work now I would, not because of the medicine, but the CPD. I know many experienced and dedicated GPs who feel the same.”

“The new system means that I need to consider CPD constantly. I work part time in clinical/mainstream general practice and the 50 hours per year is equivalent to 3 weeks of work time for me.”

“It has increased my stress and forced me to reduce my clinical hours for CPD…it takes time out of my practice. We’re already under pressure and it will definitely have a negative effect on most GPs— In our practice two GPs are going to retire early due to the new CPD system.”

“Many of my colleagues are so depressed about the horrible time-wasting effort involved now for so little educational gain (certainly not what I would want to spend my precious time learning) that many of us are considering giving up on medicine entirely. Why bother any more?”

“It is causing me a lot of stress and anxiety. It is also having a negative impact on my learning – for the first time in my life, I am not enjoying updating my medical knowledge, which has always previously been something I have done with enthusiasm.”