Financial costs for teaching in rural and urban Australian general practices: is there a difference?

Abstract

Objective: To determine if the financial costs of teaching GP registrars differs between rural and urban practices. Design: Cost-benefit analysis of teaching activities in private GP for GP vocational training. Data were obtained from a survey of general practitioners in South Australia and Western Australia. Setting and participants: General practitioners and practices teaching in association with the Adelaide to Outback General Practice Training Program or the Western Australian General Practice Training. Main outcome measures: Net financial effect per week per practice. Results: At all the training levels, rural practices experienced a financial loss for teaching GP registrars, while urban practices made a small financial gain. The differences in net benefit between rural and urban teaching practices was significant at the GPT2/PRRT2 (−$515 per week 95% CI −$1578, −$266) and GPT3/PRRT3 training levels (−$396 per week, 95% CI (−$2568, −$175). The variables contributing greatest to the difference were the higher infrastructure costs for a rural practice and higher income to the practice from the GP registrars in urban practices. Conclusion: There were significant differences in the financial costs and benefits for a teaching rural practice compared with an urban teaching practice. With infra- structure costs which include accommodation, being a key contributor to the difference found, it might be time to review the level of incentives paid to practices in this area. If not addressed, this cost difference might be a disincentive for rural practices to participate in teaching.