Practice owners are hesitant to speak publicly about the impact payroll tax could have on their practice for fear of inadvertently sparking a payroll tax audit. Doctors submitted their stories to AMA (NSW) on the condition of anonymity. If you want to share your story, email workplace@amansw.com.au.
Overworked, underpaid, and unappreciated
First, I would like to thank you for being the only body that cares about us. We feel that we are left alone and we don’t know where to go to complain or who would hear our voices. GPs are working hard and we feel the government is working against us.
Our income for the last two to three years has dropped dramatically due to the pandemic. Our expenses skyrocketed due the medical supply companies increasing the prices on some items – especially PPE. We also had to adapt our practices for Telehealth (cameras , remote access , changing servers , changing phone system, employing more staff to handle calls, staff training).
They wanted us to stay open during the pandemic, but due to our location our practices were hit very hard. We had to close a few times to deep clean our centres, as our local area was a COVID hotspot in Sydney … Almost all of our doctors got COVID-19 and our staff too. On many occasions, we were left with one or two staff instead of four to six. Many times our doctors had to work 12-14 hrs in one day just to cover for their sick colleagues.
Our income has dropped dramatically and the government support payments were not enough to cover any part of our expenses … I’m seriously considering closing the practices we have one by one and moving overseas where we would be more appreciated.
Income has dropped by 20% to 30% in the last 2.5 years.
How can we sustain a business like this ?
We are really left alone to struggle and everyone is chopping a piece of us … honestly there is nothing left in us. We are destroyed physically, mentally and financially … over worked, under paid and absolutely unappreciated.
Anonymous Sydney GP
Risk to teaching practices
We are also a very popular teaching general practice with high regard from medical students and registrars. Our mission is to provide excellence in teaching and positive experiences working in a rural area.
Our payroll is larger due to registrar salary payments just to start. The added complexity is due to these teaching/supervisor roles it is almost impossible to not get caught with payroll tax as funds are directed to the practice for our student & registrar preceptors & supervisors even though all GPs are independent contractors.
Many of our GPs work beyond the practice but it seems most of their roles do not look the same as their GP work. Eg: GP Synergy educators, university tutors, employed by LHD in ED, working in RACF…
I feel that especially in rural areas where we are trying to increase the interest in general practice and expose students, pre-vocational doctors as well as GP registrars to quality care, there is a true risk we turn our practice into a set of rooms for lease with minimal interactions to avoid an overwhelming tax burden. This is totally contrary to the high quality general practice we have aimed to achieve.
GP in Distribution Priority Area
Afraid of bankruptcy
I have a small GP practice with eight GPs, all part time, a total of four GPs at the practice per day.
We are on the coast less than two hours from Sydney in a lovely town. Recruitment should be easy. We are young, enthusiastic and have a lovely team. It is private billing. We all work really hard and love our work and our community.
I am the director of the practice as the sole owner and I work hard. One to two days a week on management, two and a half days as a GP. Like almost all GP owners I am not paid a cent for being a director. The money I lose by not working as a GP I get back in profit distributions.
Depending on interpretation of payroll tax I could lose $120,000 straight away if five years retrospective money was taken. Going forward $25,000 to $30,000 per year.
I already forfeit more than 40% of my income being a director and running a practice. Revenue NSW is trying to take more than 15 to 25% of my operating profit per annum by misconstruing a well understood concept in general practice about contractors intentionally to gouge money out of a group that the public misunderstand as more wealthy or fortunate than we actually are.
These taxes are doing grievous harm by further placing immense strain on our practice to spend tens of thousands of dollars changing our structure for no reason other than to avoid OSR creating loopholes for themselves to price gouge us.
We are running businesses that most would describe as a charity (by how poorly they profit us due to decades of underfunding and price cuts).
Enough is enough.
We are afraid of bankruptcy, endless ongoing price cuts to our profession, with increases year on year in GP stress, suicide and mental health. We are tired of the underfunding, the public slamming of our profession.
We need support. Not sneaky dodgy tax rips by Revenue NSW from an already deeply underfunded system. We are running non corporate GP practices largely out of generosity and a desire to run honest, caring services instead of working in corporate sausage factories who rort Medicare and who have no interest in public health.
– Regional GP
“This additional tax will decimate general practice businesses which will be detrimental to population health.”
– Western Sydney GP
Substandard care
If it is not financially viable to run our practice in a manner that permits optimal patient care and outcomes, then I would elect to close our practice entirely (rather than restructuring our systems into a fragmented model with substandard care that then ticks Revenue NSW’s boxes in relation to what is deemed a contractor relationship).
– Rural GP
Impact on rural and regional patients
Most of our practices already run with permanently closed books. A very sad situation locally, and if our practice is forced to wind up as well due to lack of financial viability, I just don’t know where the 20% of our population that we look after will be able to go to seek primary care services.
– Rural GP
Mercenary tax
I am a single owner GP owner principal for a small rural practice. Thank you for fighting on my behalf. The public would not truly believe the mercenary nature of this pursuit by the government. Please pursue this on behalf of general practice.
– Rural GP