THE recent death by suicide of one of our GP colleagues, Dr Ezha Lau, in Sydney felt like a tragedy for her community but hit another level for me as a fellow female GP with a young family. It felt eerie.
Dr Lau was one of us in a system that has seen reductions in funding, resources and workforce, each contributing to increasing workplace stress and definitely one that does not value the type of medicine most female GPs practise.
Reflecting on my own practice as a female GP, I was recently pregnant and gave birth during the COVID-19 pandemic. Like most female GPs, I am a contractor and do not get maternity leave. Along with the joy of being pregnant, I found myself trying to balance that with the stress and unknowns of being pregnant during the COVID-19 pandemic while still trying to maintain clinical work for as long as possible. To address the changing requirements for COVID-safe practice and my own concerns, I found myself moving to telehealth consults only. Inevitably, my earnings decreased as I offered fewer care plans and health assessments, which remunerate higher than standard consults. My bookings dipped as some patients needed face-to-face consults and I was unable to provide these.
My challenges were specific to being female and pregnant at the time, but even without the pandemic, female GPs bear an additional burden in the workforce simply because of the nature and scope of our practice. We see more complex patients, see them for longer, and do more non-billable administrative work. Anecdotally, most of us find it harder to privately bill our patients compared with our male counterparts.
A joint report by the World Health Organization and the International Labour Organisation shows that women working in health care earn, on average, 24% less than men. Previously in Australia, this has been estimated to be between 22% and 25% less for female GPs (here and here).
One may argue that female GPs are doing the same amount of work for less compared with male GPs, but the answer often lies within our scope of practice. Female GPs are much more likely to see patient presentations for psychological symptoms and women’s health than their male counterparts, who are more likely to see presentations of the musculoskeletal system, respiratory system, and skin.
There is an incredible amount of complexity that goes into managing mental health as any GP will tell you, and often female GPs are more likely to address social issues such as housing or domestic violence as well, which adds to the complexity of a consult. Most female GPs anecdotally, and as reported in the media, struggle to privately bill consults for these reasons. Formal statistics on this are lacking but, in my experience, women are expected to be empathetic and altruistic. Combined with the complexity of our patients with regards to their socio-economic situation, my colleagues and I have often found it difficult to privately bill our patients.
On the day I started charging a private fee rather than bulk-billing, half of my patients asked to be bulk billed. In my opinion, this is not an experience some of my male colleagues have had in practice when shifting to private billing.
Female GPs also tend to see patients for longer, possibly due to the complexity of the consult but also to manage more issues per consult. In the long term, this appears to lead to better health outcomes in terms of needing to see their patients less often, prescribing less, and our patients being admitted to hospital less.
For those who offer bulk-billing, performing longer consults does not translate into a higher income, as the Medicare rebate per unit of time is less for a longer consult than for a standard consult. We also tend to perform a higher proportion of non-billable administrative work, again likely linked to the complexity of our consults. I can remember working late for several evenings filling out paperwork for community housing, the National Disability Insurance Scheme (NDIS), and psychological therapy referrals as well as on the phone trying to get my patient seen by the community mental health outreach team.
Having children seems to also explain some of the pay gap, as female GPs with children earn $30 000 per year less than comparable female GPs without children. But male GPs with children were found to earn $45 000 more than comparable male GPs without children in a 2016 report. Females often tend to take on the unpaid task of domestic labour and raising children and this is likely the case in general practice as well.
The recent announcement of the changes in continuing professional development (CPD) measurement will likely impact female GPs with young children more as it reduces the flexibility of options for completing the educational requirements. As proposed, GPs will be required to perform 50 hours of CPD each year and there is no reduction in the annual total hours if the GP works part-time. I’ve already had to cut my hours down in my clinical work while raising our baby. I struggle to think about how I can fit the unpaid task of new CPD requirements into my schedule.
GPs all over Australia are struggling with burnout and, anecdotally, quite a few are looking to retire early, cut down their hours or find other sources of income. This has never been more pronounced in my group of female GP colleagues.
Our patients seem more complex, and our work and hours are renumerated less, and we often must balance this with the demands motherhood and family place upon us. There does not appear to be any financial reward in managing complex conditions, beyond the altruistic.
We have been doing this for years, but there has been no tangible change to make general practice funding more equitable for females, despite there being several years of evidence pointing the problem out.
This is not a conversation about male versus female GPs, but this is a case for a more nuanced look at the way primary care is funded. GPs in general seem to be struggling to get more crumbs added to our already woeful level of funding, but female GPs especially seem to get an even lower portion of the slice.
It affects the care we can provide, but more importantly, impacts our own mental health.
Dr Aajuli Shukla is a Sydney-based GP, and a Deputy Medical Editor with the Medical Journal of Australia.
If this article has raised issues for you please reach out to any of the following resources:
DRS4DRS: 1300 374 377
Hand-n-Hand Peer Support ... www.handnhand.org.au
If you or someone you know is having suicidal thoughts, there are people here to help. Please seek out help from one of the below contacts:
Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners.
If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.
Dr Lau was one of us in a system that has seen reductions in funding, resources and workforce, each contributing to increasing workplace stress and definitely one that does not value the type of medicine most female GPs practise.
Reflecting on my own practice as a female GP, I was recently pregnant and gave birth during the COVID-19 pandemic. Like most female GPs, I am a contractor and do not get maternity leave. Along with the joy of being pregnant, I found myself trying to balance that with the stress and unknowns of being pregnant during the COVID-19 pandemic while still trying to maintain clinical work for as long as possible. To address the changing requirements for COVID-safe practice and my own concerns, I found myself moving to telehealth consults only. Inevitably, my earnings decreased as I offered fewer care plans and health assessments, which remunerate higher than standard consults. My bookings dipped as some patients needed face-to-face consults and I was unable to provide these.
My challenges were specific to being female and pregnant at the time, but even without the pandemic, female GPs bear an additional burden in the workforce simply because of the nature and scope of our practice. We see more complex patients, see them for longer, and do more non-billable administrative work. Anecdotally, most of us find it harder to privately bill our patients compared with our male counterparts.
A joint report by the World Health Organization and the International Labour Organisation shows that women working in health care earn, on average, 24% less than men. Previously in Australia, this has been estimated to be between 22% and 25% less for female GPs (here and here).
One may argue that female GPs are doing the same amount of work for less compared with male GPs, but the answer often lies within our scope of practice. Female GPs are much more likely to see patient presentations for psychological symptoms and women’s health than their male counterparts, who are more likely to see presentations of the musculoskeletal system, respiratory system, and skin.
There is an incredible amount of complexity that goes into managing mental health as any GP will tell you, and often female GPs are more likely to address social issues such as housing or domestic violence as well, which adds to the complexity of a consult. Most female GPs anecdotally, and as reported in the media, struggle to privately bill consults for these reasons. Formal statistics on this are lacking but, in my experience, women are expected to be empathetic and altruistic. Combined with the complexity of our patients with regards to their socio-economic situation, my colleagues and I have often found it difficult to privately bill our patients.
On the day I started charging a private fee rather than bulk-billing, half of my patients asked to be bulk billed. In my opinion, this is not an experience some of my male colleagues have had in practice when shifting to private billing.
Female GPs also tend to see patients for longer, possibly due to the complexity of the consult but also to manage more issues per consult. In the long term, this appears to lead to better health outcomes in terms of needing to see their patients less often, prescribing less, and our patients being admitted to hospital less.
For those who offer bulk-billing, performing longer consults does not translate into a higher income, as the Medicare rebate per unit of time is less for a longer consult than for a standard consult. We also tend to perform a higher proportion of non-billable administrative work, again likely linked to the complexity of our consults. I can remember working late for several evenings filling out paperwork for community housing, the National Disability Insurance Scheme (NDIS), and psychological therapy referrals as well as on the phone trying to get my patient seen by the community mental health outreach team.
Having children seems to also explain some of the pay gap, as female GPs with children earn $30 000 per year less than comparable female GPs without children. But male GPs with children were found to earn $45 000 more than comparable male GPs without children in a 2016 report. Females often tend to take on the unpaid task of domestic labour and raising children and this is likely the case in general practice as well.
The recent announcement of the changes in continuing professional development (CPD) measurement will likely impact female GPs with young children more as it reduces the flexibility of options for completing the educational requirements. As proposed, GPs will be required to perform 50 hours of CPD each year and there is no reduction in the annual total hours if the GP works part-time. I’ve already had to cut my hours down in my clinical work while raising our baby. I struggle to think about how I can fit the unpaid task of new CPD requirements into my schedule.
GPs all over Australia are struggling with burnout and, anecdotally, quite a few are looking to retire early, cut down their hours or find other sources of income. This has never been more pronounced in my group of female GP colleagues.
Our patients seem more complex, and our work and hours are renumerated less, and we often must balance this with the demands motherhood and family place upon us. There does not appear to be any financial reward in managing complex conditions, beyond the altruistic.
We have been doing this for years, but there has been no tangible change to make general practice funding more equitable for females, despite there being several years of evidence pointing the problem out.
This is not a conversation about male versus female GPs, but this is a case for a more nuanced look at the way primary care is funded. GPs in general seem to be struggling to get more crumbs added to our already woeful level of funding, but female GPs especially seem to get an even lower portion of the slice.
It affects the care we can provide, but more importantly, impacts our own mental health.
Dr Aajuli Shukla is a Sydney-based GP, and a Deputy Medical Editor with the Medical Journal of Australia.
If this article has raised issues for you please reach out to any of the following resources:
DRS4DRS: 1300 374 377
- NSW and ACT ... 02 9437 6552
- Victoria ... 03 9280 8712
- Tasmania ... 1800 991 997
- Queensland ... 07 3833 4352
- WA ... 08 9321 3098
- SA and NT ... 08 8366 0250
- NSW ... https://www.mbansw.org.au/
- Queensland ... https://mbaq.org.au/
- Victoria ... https://www.vmba.org.au/
- South Australia ... http://doctorshealthsa.com.au/resources/medical-benevolent-association-of-sa
Hand-n-Hand Peer Support ... www.handnhand.org.au
If you or someone you know is having suicidal thoughts, there are people here to help. Please seek out help from one of the below contacts:
- Lifeline| 13 11 14 | 24-hour Australian crisis counselling service
- Suicide Call Back Service| 1300 659 467 | 24-hour Australian counselling service
- beyondblue| 1300 22 4636 | 24-hour phone support and online chat service and links to resources and apps
Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners.
If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.
Loading comments…
More from this week
War and conflict
4 May 2026
The Bondi Beach terror attack mobilised a team of volunteer medics. Here’s what we learned
Substance-related disorders
4 May 2026
Anabolic steroids expose a blind spot in modern harm reduction
Mental health
4 May 2026
Dissociation and Dissociative Identity Disorder: reframing trauma-related presentations
Neurology
4 May 2026
Understanding variability in stuttering
Newsletters
Subscribe to the InSight+ newsletter
Immediate and free access to the latest articles
No spam, you can unsubscribe anytime you want.
By providing your information, you agree to our Access Terms and our Privacy Policy. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.