The percentage of GPs who say they are fully bulk billing patients halved and the average cost to see a doctor went up by $10 in a year, according to Australia's peak body for GPs.
The Royal Australian College of General Practitioners' annual survey of doctors from across the country showed the proportion of GPs who bulk billed all their patients went from from 24 per cent in 2022 to 12 per cent in 2023.
It also found GPs were charging an average of $74.66 for a 20-minute appointment this year, compared to an average fee of $64.02 in 2022. These figures included the Medicare rebate of about $40.
Wollongong GP and RACGP representative Dr Rowena Ivers said these figures were reflective of how difficult conditions were for Illawarra GPs, who have been battling staff shortages, growing workloads and rising costs in recent years.
This time last, these conditions pushed a number of long-standing Illawarra practices into closure, or caused them to shifting to private billing just to make ends meet.
Dr Ivers said she believed the number of GPs fully bulk-billing would be similar in the Illawarra to the 12 per cent quoted in the national report.
"It's quite a drop from the previous year and our community definitely sees that," she said,
"Traditionally in Wollongong we did have a number of clinics who bulk billed pretty much all of their patients, and that's changed quite rapidly - I think that you'd be pressed to find a practice that's fully bulk-billed now."
The report showed 30 per cent of GPs bulk billed a majority of their patients (down from 40 per cent a year earlier) while 44 per cent bulk-billed a minority of their patients.
The RACGP report also showed there was still high demand for GPs, with almost nine in 10 people seeing their doctor and receiving an average of 7.9 episodes of care each year.
Dr Ivers said it remained difficult for patients to get in to see a doctor in Wollongong, with the workforce shortage still causing a problem: the report showed almost three in 10 GPs intend to retire in the next five years.
"A lot of GPs who've been around a while are reporting to me six week waiting times, but some newer GPs do have shorter waiting times," she said.
She said the region's new and extended hours urgent care centres offered a different type of care to GPs, and had done little to change this landscape.
Dr Ivers said the Medicare payment from the government still went nowhere near covering the full cost of GP appointments, despite a new incentive - which came in this month - for GPs who bulk-bill children, concession-card holders and pensioners.
Under these changes to the Medicare Benefits Scheme, Wollongong and Shellharbour GPs will receive $14 more as a bonus (with the incentive going up from $6.60 to $20.65) for these patients.
Dr Ivers said this was a welcome, but small, change - with the increased incentives unlikely to cover the rising costs of staff wages, rent and medical insurance for most GPs.
RACGP President Dr Nicole Higgins said GPs were much cheaper for the health system than having patients end up in hospital, and called for more government efforts to address the issues.
"When a person goes to a hospital emergency department, it costs the government and taxpayers, on average, over $600 - and much more if they're admitted," she said.
"Whereas it costs only $80 for 20-40 minutes with their GP."
"Our report is further evidence that we are facing a looming shortfall of GPs, and we need to do much more to attract and retain this essential workforce, for the health of Australians now and into the future."
Doctors say one of the biggest threats to their viability is a new new interpretation of payroll tax, which has historically not applied to GPs because they work under independent agreements.
"Now practices are facing closure, and having to raise patients' out-of-pocket fees, because they can't absorb this extra tax," Dr Higgins said.
"This needs to be addressed urgently, we need a consistent approach to this tax across Australia and settings for general practice to thrive in every community."
In August, the NSW Government agreed to pause payroll tax audits for GPs and their practices for 12 months to allow for ongoing consultation with doctors.
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