The Productivity of Doctors in Australia: The ‘Flat of the Curve’ and Beyond?

Physicians are one, albeit key, input into the production of better health and well being. There are two parts to the measurement of doctor productivity: activities performed and the value of those activities to society, via their impact on health and welfare. The former is easiest to measure, whilst the latter is more difficult since prices are unlikely to reflect patients valuations of services provided. In Australia, the quantity of services per doctor has been falling whilst the revenue from fees charged per FTE doctor has been increasing. This suggests that the increase in revenue per doctor is due entirely to increases in real prices. This is against a context of a reduction in the supply of hours by GPs and specialists balanced against weak evidence of an increase in the quality of GP services. Fewer services are being provided and costs are rising with unknown changes in quality. The net effect on population health depends on whether the forgone health gains of patients deterred from using health care due to price rises are lower than the potential increase in health from an increase in quality of care for those who do visit their GP. Further research should focus on the routine measurement and valuation of quality in clinical practice, with a focus on those aspects of doctor activity that patients’ value. As with many countries, there is little empirical evidence to determine the most cost-effective policies to improve doctor productivity.