Medfin Health Practioners Survey

Medfin Health Practioners Survey

NAB/MEDFIN HEALTH PRACTITIONE RS SENTIMENT SURVEY AUGUST 2016 Date August 2016 | Author Behavioural & Industry Economics, NAB Group Economics CONTENTS Key points Business conditions and confidence Key Drivers of business conditions and confidence page 6 Sales revenue Profitability Staffing levels Cash flow Capital expenditure Costs page 11 Changes in total labour costs Changes in purchase costs Changes in overhead costs Changes in prices of services provided Capacity utilisation page 15 Ease of borrowing page 16 Growth constraints page 17 Growth drivers Impact on business of selected issues Bulk billing Practice managements systems (PMS) page 21 About the survey - demographics page 23 2 page 3 page 5 page 9 page 10 page 14 page 18 page 19 page 20 KEY POINTS Health practitioners reported positive business conditions (+38) in the last 6 months, led by strong sales and profits. The impact on staffing levels from very strong trading conditions was also positive. Overall, business conditions for health practitioners were stronger than the broader economy based on the Q2 NAB Quarterly Business Survey (+9).

Business confidence is very strong (+54). The spread between the best and worst is very narrow - except in rural areas and the smallest practices, where confidence is notably lower. Overall, confidence among health practitioners is also significantly higher than the broader economy (+1). Large practices and other practitioners are out-performing in terms of sales and profitability, but dental practitioners and smaller firms are the most confident in relation to staffing. Cash flow positions are positive across the board and capital expenditure is expected to continue growing in all regions, states, practitioner types and practice sizes (except the very smallest) over the next 6 months. Costs are increasing and expected to continue rising - a net 38% of health practitioners expect labour costs to rise in the next 6 months, 33% anticipate higher purchase costs and 44% higher overheads. Around 37% (net) of all health practitioners expect to increase their services charges in the next 6 months. With costs rising faster, this could be a sign that profit margins may erode. Last 6 months Next 6 months Business Conditions 38 Business Confidence 54 - Sales 56 - Sales 72 - Profitability 43 - Profitability 64 - Cash flow 44 - Cash flow 57 - Staffing levels 17 - Staffing levels 26 18 - Capital expenditure 24 - Capital 3 expenditure KEY POINTS Although capital expenditure measures within the survey are very positive, health practitioners are currently operating at just 76% capacity - below 82.1% recorded in Recreation & Personal Services (including Health) reported in the latest Quarterly Business Survey. Capacity utilisation is highest for dental practitioners (80%) and lowest for GPs (70%). Overall, health practitioners considered the ease of obtaining borrowing for their businesses over the last 6 months to be neutral, but it is expected to be more difficult in the next 6 months. Just over 1 in 10 practitioners also indicated they have no borrowing requirements in the next 6 months. Government policy is the biggest impediment for health practitioners to growing their business - but rated only a minor constraint. But for GPs, it is significant. A lot more GPs also cite cost increases, finance and digitisation as impediments to growing their business. Dental practitioners see foreign competition as a bigger constraint, while other practitioners are more concerned about the availability of suitable staff and capacity constraints. Health practitioners believe patient recommendations are the most significant growth drivers for their business, followed by increased demand driven by growing local population and online marketing. Bulk billing is a far bigger growth driver for GPs than any other practitioner group.

Overall, more health practitioners view overall digitisation and payment digitisation positively in relation to their business, but more view the 6th Pharmacy Agreement, Medicare pathology payment changes and Medicare rebate indexation negatively, particularly GPs. Fewer practitioners in regional areas, VIC/TAS, GPs and practices employing more than 20 people would continue to bulk bill for their services as a result of proposed changes to Medicare. In contrast, more health practitioners in rural areas, capital cities, NSW/ACT, QLD dental and other practitioners and those employing 1 person and between 6-10 people would continue to do so. The vast majority of health practitioners believe the patient management systems (PMS) they currently use are moderately effective, but most would not considering changing PMS in the next 12 months - bar WA where the effectiveness of their current PMS was also rated lowest. 4 BUSINESS CONDITIONS & CONFIDENCE Business conditions for health practitioners were positive (+38) in the last 6 months based on their sales, profitability and staffing levels. But conditions varied by location, practitioner type and by the size of their practice (measured by number of employees). Conditions were strongest in regional areas (+46), SA/NT - from a smaller sample size (+50), other practitioners - e.g. hospitals, pathology, optometry, physios. (+46) and in practices employing 20+ people (+56). Conditions were weakest in rural areas (-7), NSW/ACT (+27), for GPs (+32) and in practices employing 1 person (+7). Business confidence was also positive (+54). Confidence was highest in capital cities (+57), SA/NT (+63), for other practitioners (+60) and in practices employing 20+ people (+67). Conditions and confidence for health practitioners is much stronger than in the broad economy (measured by NABs Quarterly Business Survey (+38 versus +9 for conditions and +54 versus +1 for BUSINESS CONDITIONS (net balance, last 6 months) 60 50 40 30 20 10 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ACT Rural* Regional

Overall -10 Capital City 0 BUSINESS CONFIDENCE (net balance, next 6 months) 70 60 50 40 30 20 20+FTE* 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* 11 to 19 FTE 5 Regional Overall 0 Capital City 10 KEY DRIVERS - SALES REVENUE SALES REVENUE 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Overall 90 80 70 60 50 40 30 20 10 0 VIC/TAS (last 6 months, net balance) The index for sales performance over the last 6 months was positive (+56) and it contributed the most to overall business conditions.

Again, however, conditions varied by location practitioner type and by the size of their practice. Sales were strongest in capital cities (+59) but only marginally ahead of regional areas (+57), in SA/NT (+70), other practitioners (+64) and in practices employing 20+ people (+83). Sales were positive but notably weaker in rural areas (+20), NSW/ACT (+35), for dental practitioners (+48) and practices employing 1 person (+10). Expectations for sales over the next 6 months are buoyant (+72) in all areas, by all practitioner types and all practice sizes. Sales are expected to recover notably in rural areas (+60), in NSW/ACT (+71) and VIC (+71) and in small practices (+40). SALES REVENUE (next 6 months, net balance) 100 80 60 40 6 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Overall 0 VIC/TAS 20 KEY DRIVERS - PROFITABILITY PROFITABILITY (last 6 months, net balance) 80 60 The index for profitability over the last 6 months was positive (+43) and was the second biggest contributor to overall business conditions. Profitability was strongest in capital cities (+50), SA/NT (+75) and WA (+70), for dental practitioners (+64) despite having the lowest sales, and in practices employing 11-19 people (+69) and 20+ people (+67). Profitability was negative in rural areas (20), a least positive in VIC/TAS (+18) and NSW (+24), for GPs (+33) and in practices employing 1 person (+10). Profit expectations for the next 6 months are strong (+64) in all areas, by all

practitioner types and all practice sizes. Profitability is expected to improve most in rural areas (+20), in NSW/ACT (+59) and VIC (+53), for other practitioners (+75) and in smaller practices employing 1-10 people. 40 20 0 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Overall -40 VIC/TAS -20 PROFITABILITY 7 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ACT Rural* Regional Overall 90 80 70 60 50 40 30 20 10 0 Capital City (next 6 months, net balance) KEY DRIVERS - STAFFING LEVELS STAFFING LEVELS 20+FTE* 11 to 19 FTE 6 to 10 FTE

2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ACT Rural* Regional Capital City Overall 60 50 40 30 20 10 0 -10 -20 -30 VIC/TAS (last 6 months, net balance) STAFFING LEVELS On balance, health practitioners have employed more staff in the last 6 months (+17). Staffing levels were strongest for firms employing 6-10 people (+47) and in regional areas (+38). Staffing levels were positive in all Eastern seaboard states, led by QLD (+25) and NSW/ACT (+24) and neutral in SA/NT and WA. Other health practitioners (+29) were most active in employing staff, but staffing levels were cut back in rural areas (-20). Further employment gains are predicted in the next 6 months (+26). Health practitioners employing 2-5 people (+36), dental practitioners (+35), regional operators (+33) and those located in NSW/ACT (+29), VIC/TAS (+29) are the most optimistic for employment/staffing in the next 6 months. (next 6 months, net balance) 40 30 20 10 0 -10 20+FTE* 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT

Rural* Regional 11 to 19 FTE 8 Capital City Overall -30 VIC/TAS -20 CASH FLOW CASH FLOW (last 6 months, net balance) 100 80 60 Overall, cash flow positions over the past 6 months were positive (+44). Cash flow positions were strongest in capital cities (+54), SA/NT (+88), for dental practitioners (+57) and for practitioners employing 11-19 people (+69). They were least positive in rural areas (+20), NSW/ACT (+18) and VIC/TAS (+24), for GPs (+24) and in the smallest practices (+10). Cash flow positions are expected to improve across the board (+57) over the next 6 months. They are expected to improve most in NSW/ ACT (+53), VIC/TAS (+47), in rural areas (+40) and for other health practitioners (+71). 40 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CASH FLOW (next 6 months, net balance) 100 80 60 40 9 20+FTE* 11 to 19 FTE 6 to 10 FTE

2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CAPITAL EXPENDITURE CAPITAL EXPENDITURE (last 6 months, net balance) 50 Overall, capital expenditure increased mildly over the past 6 months (+18). Capital expenditure increased most in rural areas (+40), in NSW/ACT (+35), for other practitioners (+21) and in practices with 1119 employees (+38). Smaller increases were reported in capital cities (+15), VIC/TAS (+12), by dental practitioners (+13) and in practices with 2-5 employees (+7). Overall, capital expenditure is expected to increase somewhat more in the next 6 months (+24), relative to the last 6 months. Positive outcomes are also expected across the board, bar practices employing 1 person (-10). Expectations for capital expenditure were also been pared back in rural areas (+20), VIC/TAS (+6) and SA/NT (+13). The biggest increases are expected in practices employing 11-19 people (+69), regional areas (+43), QLD (+30) and GPs (+33). 40 30 20 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional

Capital City Overall 0 VIC/TAS 10 CAPITAL EXPENDITURE (next 6 months, net balance) 80 60 40 20 10 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Overall -20 VIC/TAS 0 COSTS - CHANGES IN LABOUR COSTS CHANGES IN LABOUR COSTS (last 6 months, net balance) 80 In net terms, labour costs rose for 42% of health practitioners over the last 6 months. Higher labour costs were reported by similar numbers of health practitioners in all regions. But labour costs rose for more practitioners in QLD (+60), for other health practitioners (+50) and for those employing 11-29 employees (+62). Labour cost pressures were lowest in VIC/TAS (+29), for dental practitioners (+35) and in practices employing 1 person (+20). In net terms, only 38% of firms are anticipating higher labour costs in the next 6 months. Fewer practitioners in regional (+29) and rural areas (+20), QLD (+25), GPs (+24) and practices employing 1 person (0), those employing 2-5 (+36) and 11-19 people (+54) expect labour costs to rise, relative to the last 6 months. In contrast, significantly more firms in WA 60 40 20+FTE* 11 to 19 FTE

6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CHANGES IN LABOUR COSTS (next 6 months, net balance) 80 60 40 11 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 COSTS - CHANGES IN PURCHASE COSTS CHANGES IN PURCHASE COSTS (last 6 months, net balance) 80 60 In net terms, purchase costs rose for 31% of health practitioners over the last 6 months. Purchase costs increased most in rural areas (+60), SA/NT (+63), for dental practitioners (+48) and for those employing 6-10 people (+40). They rose by less in regional areas (+19), VIC/TAS (+12), for other practitioners (+11) and for those employing 20+ people (+17). Overall, more firms expect their purchase costs to increase in the next 6 months (33%).

Notably more practitioners in VIC/TAS (+29), other practitioners (+36) and those employing 20+ people (+33) expect their costs to increase relative to the last 6 months. In contrast, fewer anticipate higher purchase costs in rural areas (+40), NSW/ACT (+41), GPs (+29), dental practitioners (+35) and those employing 1 person (+10). 40 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CHANGES IN PURCHASE COSTS (next 6 months, net balance) 80 60 40 12 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 COSTS - CHANGES IN OVERHEADS CHANGES IN OVERHEAD COSTS (last 6 months, net balance) 100 80 In net terms, overhead costs rose for 44% of health practitioners over the last 6 months.

Overall, they increased most in rural areas (+80), NSW/ACT (+65), for GPs (+48) and in practices employing 1 person (+60). Rising overhead costs were less prevalent in regional areas (+33), QLD (+25), for dental and other practitioners (+43) and in practices employing 2-5 people (+36). Overall, 44% of health practitioners expect their overhead costs to increase in the next 6 months. Overheads are expected to rise notably in WA (+40) and SA/NT (+25) relative to the last six months, and in the largest practices (+83). In contrast, fewer firms in NSW/ACT (+47), VIC/TAS (+35), GPs (+24) and in practices employing 1 person (+40) and 6-10 people (+27) expect their overheads to rise. 60 40 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CHANGES IN OVERHEAD COSTS (next 6 months, net balance) 100 80 60 40 13 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional

Capital City Overall 0 VIC/TAS 20 CHANGES IN PRICES OF SERVICES PROVIDED CHANGES IN PRICES OF SERVICES PROVIDED (last 6 months, net balance) 60 40 In net terms, 22% of all health practitioners increased the price of the services they provided over the last 6 months. However, this varied widely between rural areas (+40) and capital cities (+24), between NSW/ACT (+35) to SA/NT (+13) across states, by other (+32) to dental (+9) by practitioner type and from practices employing 20+ people (+50) to those employing 2-5 people (+7) by business size. Around 37% of health practitioners (net) expect to increase the price they charge for their services in the next 6 months. Given a net 38% are also anticipating higher labour costs, 44% higher overheads and 33% higher purchasing costs, this may be pointing to lower profit margins in the next 6 months. 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ACT Rural* Regional Overall 0 Capital City 20 CHANGES IN PRICES OF SERVICES PROVIDED (next 6 months, net balance) 80 60 40 14 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA*

SA/NT* QLD VIC/TAS NSW/ ACT Rural* Regional Overall 0 Capital City 20 CAPACITY UTILISATION CAPACITY UTILISATION (%) Health practitioners are currently operating at 76% capacity. When compared NABs Quarterly Business Survey (QBS), this may indicate spare capacity in this sector. Capacity utilisation in Recreation & Personal Services (including Health) was recorded at 82.1% in the Q2 2016 QBS - above its longterm average (80.3%). Capacity utilisation levels among health practitioners does however vary by location, practitioner type and by the size of their practice. Capacity utilisation was highest in rural areas (83%) and lowest in regional areas (72%). By state, it was highest in WA (86%) and lowest in QLD (69%). By practitioner type, it was highest for dental practitioners (80%) and lowest for GPs (70%). By business size, it was highest for practitioners employing more than 20 people (83%) and lowest for those employing 1 person (67%). 100 80 60 40 15 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Overall

0 VIC/ TAS 20 EASE OF BORROWING EASE OF BORROWING FOR YOUR BUSINESS Easier (last 6 months) Overall, health practitioners considered the ease of obtaining borrowing for their businesses over the last 6 months to be neutral. But borrowing conditions were notably harder in rural locations (-20), NSW/ACT (24), WA (-20), for GPs (-19) and firms employing 11-19 people (-23). Borrowing was easiest in QLD (+20) and SA/ NT (+13), for dental practitioners (+17) and firms with 6-10 employees (+20). The majority of firms in most groups had no borrowing requirements, with the notable exceptions of dental practitioners and firms employing 1 person. Overall, borrowing is expected to become more difficult in the next 6 months (-7), particularly in WA (-30) and SA/NT (-25). While just over 1 in 10 firms overall have no borrowing requirements in the next 6 months, 1 in 5 firms in QLD, WA and 1 in 5 GPs do not require any borrowing. 40% 30% 20% 10% 0% -10% net diffi culty 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Harder Overall -30% VIC/TAS -20% no borrowing required EASE OF BORROWING FOR YOUR BUSINESS Easier (next 6 months) 30%

20% 10% 0% -10% -20% net diffi culty 16 no borrowing required 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City Harder Overall -40% VIC/TAS -30% GROWTH CONSTRAINTS GROWTH CONSTRAINTS (OVERALL) Health practitioners overall do not believe there are significant impediments to growing their business. Overall, they identified government policy as the biggest impediment - but only a minor constraint. The availability of medical practitioners, local competition and customer demand were seen as the next biggest constraints, but again only minor. A different picture emerges by practitioner type. All practitioners rated government policy as the biggest constraint, but only GPs viewed this as significant. GPs were also notably more concerned about cost increases, finance and digitisation. Dental practitioners saw foreign competition as a much bigger constraint than did GPs and other practitioners. But other practitioners were most concerned about the availability of suitable staff and capacity constraints. Government policy Availability of practitioners Competition (local) Customer demand Cost of suitable staff Cost increases Capacity constraints Availability of suitable staff Availability/Cost of finance

Digitisation Competition (foreign) 0.5 No Constraint 1.5 Minor Constraint 2.5 Significant Constraint 3.5 GROWTH CONSTRAINTS (BY PRACTITIONER TYPE) Government policy Availability of practitioners Competition (local) Customer demand Cost of suitable staff Cost increases Capacity constraints Availability of suitable staff Availability/Cost of finance Digitisation Competition (foreign) 0.5 17 GPs No Constraint 1.5 Dental Minor Constraint 2.5 Significant Constraint 3.5 Other GROWTH DRIVERS GROWTH DRIVERS (OVERALL) Patient recommendations Health practitioners believe patient recommendations are the most significant growth drivers for their business. Growing local population driving increased demand and online marketing are the next biggest drivers. Bulk billing contributed the least to the growth of their businesses, according to all health practitioners. Again however there are significant differences by practitioner type. While patient recommendations are the most important growth driver for all health practitioners, bulk billing and increased capacity (e.g. rooms, facilities, staff) are much more important growth drivers for GPs. For dental practitioners, population and advertising are more important, while increased capacity is also a much bigger growth driver for other practitioners. Growing local population Online marketing Advertising Increased capacity Bulk billing 0.5Not A1.5 driver 2.5 3.5 4.5 5.5 6.5 7.5 8.5 cant 9.5 10.5 Signifi Driver GROWTH DRIVERS (BY PRACTITIONER TYPE) Patient recommendations Growing local population Online marketing Advertising Increased capacity

Bulk billing Not a 1.5 Driver 2.5 0.5 18 GPs 3.5 Dental 4.5 5.5 6.5 7.5 Other Signifi Driver10.5 8.5 cant 9.5 IMPACT ON BUSINESS OF SELECTED ISSUES BUSINESS IMPACTS OF SELECTED ISSUES (OVERALL) (net balance) Health practitioners were asked to rate the impact on their business of 5 selected issues. In net terms, overall digitisation and payment digitisation were viewed positively by health practitioners. In contrast, the 6th Pharmacy Agreement, Medicare pathology payment changes and Medicare rebate indexation were viewed negatively. By practitioner type, overall digitisation and payment digitisation was viewed positively by all practitioners, especially GPs. Dental practitioners were broadly neutral when it came to the impact on their business from all other issues. Medicare pathology payment changes and rebate indexation were viewed negatively by other practitioners. GPs were notably more negative than all other groups when it came the 6th Pharmacy Agreement, Medicare pathology changes and Medicare rebate indexation. Overall digitisation Payment digitisation 6th Pharmacy Agreement Medicare pathology payment changes Medicare rebate indexation Neutral 0 -1Negative Positive1 BUSINESS IMPACTS OF SELECTED ISSUES (BY PRACTITIONER TYPE) (net balance) Overall digitisation Payment digitisation 6th Pharmacy Agreement Medicare pathology payment changes Medicare rebate indexation -1Negative GPs 19 Positive1 Neutral 0 Dental Other BULK BILLING BULK BILLING (BY PRACTIONER TYPE) Around 14% of GPs bulk bill all their patients, 38% most patients, 43% some

patients and 5% do not bulk bill at all. Nearly 1 in 2 (48%) dental practitioners bulk bill some of their patients, while 52% do not. Around 7% of other practitioners bulk bill all their patients, 14% most patients, 21% some patients and 57% do not bulk bill. When asked whether they would continue to bulk bill as a result of proposed changes to Medicare, fewer practitioners in regional areas (-31), VIC/TAS (-25), GPs (-38) and employing more than 20 people (-20) would continue to do so. Practitioners in SA/NT, WA and those employing between 2-5 and 11-19 people were neutral. But more health practitioners in capital cities (+14), NSW/ACT (+20), QLD (+25), dental (+22) and other practitioners (+45) and those employing 1 person (+20) and 6-10 people (+13) would continue to offer bulk billing services. Interestingly, all providers in rural areas would continue to bulk bill. 70% 60% 50% 40% 30% 20% 10% 0% Currently bulk bill all patients Bulk bill most patients Bulk bill some patients GPs Dental Do not bulk bill Other CONTINUE TO OFFER BULK BILLING SERVICES Very Likely (net balance) 100 80 60 40 20 0 20+FTE* 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD NSW/ ACT Rural* Regional Capital City 11 to 19 FTE 20 Overall -40

Very Unlikely VIC/TAS -20 PRACTICE MANAGEMENT SYSTEMS (PMS) PRACTICE MANAGEMENT SYSTEM CURRENTLY IN USE Just over 1 in 2 (52%) surveyed GPs currently use Best Practice as their preferred practice management system (PMS). Around 1 in 3 (33%) use Medical Director and 1 in 20 (5%) use MediTech. Around 1 in 10 GPs (10%) do not currently use a PMS. The majority of dental practitioners (52%) use Dental4Windows for their PMS. Exact was next most popular (13%), followed by Oasis (9%) and Practiceworks (9%). Other PMS used by dental practitioners included My Practice (4%), Dolphin (4%) and Ultimo Dental (4%). There was a much greater variety among other health practitioners when it came to which PMS they currently use. Genie (14%) was the most popular, followed by Front Desk / Smartsoft (7%) and Optomate / Monkey Software (7%). Somewhat surprisingly, just over 1 in 5 (21%) other health practitioners dont know which PMS they currently use and 4% dont currently use a PMS. 60% GPs DENTAL OTHER 50% 40% 30% 20% 21 Don't know Genie Other FrontDesk / Smartsoft Optomate / Monkey Software Gensolve Medical Director PPMP TM2 Capable & ENote Ealth Netchiro Pratix Don't use PMS Dental4Windows EXACT Oasis Practiceworks My Practice Dolphin Ultimo Dental Don't know 0% Best Practice Medical Director Don't use PMS MediTech 10% PRACTICE MANAGEMENT SYSTEMS (PMS) EFFECTIVENESS OF CURRENT PMS (average score where 0 ="not at all & 10 ="completely) 10

On average, all health practitioners believe the PMS they use are moderately effective. However, practitioners in rural areas believe they are somewhat more effective than do those in capital cities. The greatest variation occurs by state, where VIC/TAS and QLD are much more confident in their system than practitioners in WA. There is little variation by practitioner type or by practice size. When asked if they would consider changing their PMS in the next 12 months, health practitioners where mostly negative and in all regions, states, by practitioner type and practice size. WA - where the effectiveness of their current PMS was also rated lowest - was the only exception, with more practitioners considering a change in the next 12 months. 8 6 4 Very Likely 40 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA* SA/NT* QLD VIC/TAS NSW/ACT Rural* Overall Capital City 0 Regional 2 CONSIDERING CHANGING PMS IN NEXT 12 MONTHS (net balance) 20 0 -20 -40 -60 22 20+FTE* 11 to 19 FTE 6 to 10 FTE 2 to 5 FTE 1 FTE* Other Dental GPs WA*

SA/NT* QLD VIC/ TAS NSW/ACT Rural* Regional Very Unlikely Overall -100 Capital City -80 ABOUT THE SURVEY - DEMOGRAPHICS SURVEY RESPONDENTS BY STATE WA 14% SURVEY RESPONDENTS BY PRACTITIONER NSW/ACT 23% SA/NT 11% Other 39% VIC/ TAS 23% QLD 29% Dental 32% SURVEY RESPONDENTS BY EMPLOYEE SIZE 20+emp 8% The NAB/Medfin Health Practitioners Survey was undertaken during the period from 18 July to 31 July 2016. The Survey is based on the responses of 72 health practitioners. Survey respondents are represented across a broad range of health services GPs, dental and other (e.g. hospitals, specialist medical, optometry, physiotherapy). Health practitioners are also represented by location and by practice size. 1 emp 14% 11-19 emp 18% 6-10 emp 21% 23 GPs 29% 2-5 emp 39%

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