Thank you those who responded. This year’s response was smaller than previous years – 107. Four were General Practitioners, 53 were Fellows of the College, 10 additionally were Clinical Directors and registrars were divided into senior (23 replies) and junior (15 replies) on the basis of UCPEX pass. This represents about 1/4 of RNZCUC members but may not be directly comparable to last year’s sample as the respondents may not be the same people.
While we include General Practitioners and Doctors with financial stakes in clinics in our questionnaire the numbers were so small and their circumstances diverse they have not been included in calculations.
The survey was anonymous, and we do rely on the honesty and maths of responders. Consequently, educated guesses as to the meaning of some answers had to be made.
Of the workforce 50 were contractors, 53 employees and four had financial interests in the clinic.
To provide a valid comparison, salaried doctors were converted to an hourly rate, taking into account their hours, base salary, annual leave declared, 3% Kiwisaver, ACC levy, and assuming employer paying Indemnity Insurance, College membership, MCNZ fees and CME leave pro rata. Sick leave although asked was not taken into calculations.
The question relating to “After Hours” naturally covered a number of areas (evening, night, weekend, statutory holiday). Where specified the Statutory Holiday payments/time in lieu were excluded.
Any numbers in parentheses not otherwise specified are those from last year.
The practice definitions in the survey were not highly detailed, leaving it up to the respondents to decide on the most appropriate labels for their situation,
- City= Central City
- Town= regional town
- Suburban = Not central urban area
- GP attach = attached but not integrated
- GP integrated = GP and UC staff and cases mix
- ED = DHB ED
- Attach DHB = Urgent Care attached to DHB Facility
This year by request we have also divided responses geographically, South Island and Upper/Lower North Island. Interestingly there didn’t seem to be much in the way of regional differences.
Working hours
Average hours per week (not including on call) in 2023 were 25.4, a large fall from 30.4 in the previous survey. Only 4% of doctors reported an average work week in excess of 40 hours (10% last year). The mean for weekly working hours was for employees, 28.4 (32),working longer hours than contractors 23.5 (27.7)
After hours loading
Overall, the after hours loading averaged about 13%, however it is notable that many employees had no after hours loading leading one to assume it was built into their salary.
Urgent care registrars
Base hourly rate varied ($110to $160) per hour with a mean of $129 ($123). In contrast to last year, contracted doctors in general had significantly higher hourly rates. In terms of type of clinic and region there was little significant variation. After hours loading about 16%
Senior urgent care registrars
Senior Registrars’ average hourly rate was $106 for employed Drs and $144 for those on contract with a mean of $141 (Range $78 to$350) and an after hours loading of about 10%.. The vast majority of Senior Registrars were based in the central city so location differences were not significant and neither were regional differences.
Fellows (vocationally registered without management Role)
For those Urgent Care and GP Fellows not in a management role the equivalent hourly rate varied between $100 and $325 per hour with an average of $144 (135) per hour. After hours rates averaged $168(158) but it is notable that almost all after hours loadings were less than 30%.
In general, contracted doctors had higher hourly rates than employees $155 vs $135 ($135 vs $131/hr) as in previous years.
Clinical/ Medical Directors
CD response to this survey was much smaller than previous years and is probably too small to discern trends but in responses Clinical/Medical Directors as employees have had in increase in average pay (from $165 to $174 per hour) while contractors decreased from $186 to $166 per hour on last year. Again the locality figures below may not be representative due to small sample size, but “central city ” clinics paid most while there was little difference between clinic types. CDs had the lowest after hours loading.
Annual leave
Paid annual leave to employees averaged 25 days per year – range 20-35 per year. ED(DHB) doctors all were alllowed 30 days paid annual leave per year.
CME leave and allowances
This year more contractors (11/50) had CME allowances (average $3750 and the same number had paid CME leave (average 5.9 days) in their contract, two being on DHB equivalent leave and allowance. About 25% of employees had annual CME leave (down from 50% last year) also averaging 5.9 days while half had a dollar allowance, averaging $7681 – the range being up to $16000 the latter being DHB employees. A few Doctors had CME leave but no allowance. For those with any allowance three fifths required workplace approval while the remainder were free to chose.
Peer review groups
Paid peer review groups seem to be on the increase -As in previous years few contractors had paid peer review time (8/50) and 18/53 of employees did also get paid Peer Review time, evenly spread across worksites. Only 2/10 Clinical Directors had paid Peer Review time which seems incongruous to the other roles.
Staffing levels
Only 17% of respondents said staffing levels were adequate, while 50% thought staffing mostly adequate and 33% felt they were generally inadequate. This is an improvement on last year’s result (9/44/47) but see below (closures).
Closures
Clinic closures appear (to the College) to have increased in the past year.
60% of respondents reported clinic having to close during their usual hours.
Reason given was Doctor shortage in 50% but nurse shortage also in 30% and reception shortage 7%.
One clinic closed due to Cyclone, another due to unsafe workload and another to financial unviability.
Burnout
Reporting of burnout symptoms was similar to last year – 60% but a half of these had to take action to deal with it (1/3 last year).
Plans for the next 5 years
The plans of members for the next 5 years showed a clear trend with seniority:
- CDs – 40% planning to reduce hours or leave urgent care (50% last year)
- Fellows – 14% planning to leave urgent care, 40% to reduce hours,4% to increase hours
- Senior Registrars – 8% planning to leave urgent care, 25% to reduce hours, 25% to increase hours
- Registrars 6% planning to leave urgent care, 18% to reduce hours
In the workplace
Mean scores for the following questions as below and are nearly identical to last year.
| Question | Score | Result |
| Most senior staff are supportive | 4.2 | Agree |
| My workplace supports staff wellbeing | 3.6 | Somewhat agree |
| My workplace supports me to achieve a good work/life balance | 3.6 | Somewhat agree |
| Bullying, harassment and discrimination (including racism) is not tolerated at my workplace | 4.17 | Agree |
| I know how to raise concerns/issues about bullying, harassment and discrimination | 4.2 | Agree |
| I am confident that I could raise concerns/issues about bullying, harassment and discrimination in my workplace | 4.1 | Agree |
| I can access support including debriefing from my workplace if I experience stress or a traumatic event | 3.9 | Agree |
| My workplace is supportive when experiencing difficult personal circumstances. | 4 | Agree |