more than money 2012

More than Money

Secure your win-win contract

2011

A NEGOTIATION GUIDE FOR GP REGISTRARS

More than Money 2011 An initiative of GPRA 00

About this

GuideFor many registrars, negotiating an employment contract can be a challenging process.

there are many things to consider when making the transition from the hospital system, with its standardised terms and conditions, to the more flexible world of private general practice.

While private GP clinics provide a community service, they are also businesses so there is scope to negotiate the terms and conditions of your employment contract based on the value you bring to the practice.

this guide is designed to help make contract negotiation easier for you throughout your training and post-fellowship. the scope of the guide concentrates on negotiation for GPt1 and GPt2 registrars, but many of the guidelines apply to registrars and GPs at any career stage.

At the end of the negotiating process with each practice, you should have a signed written

contract on which both parties have agreed and understand. this will go a long way towards preventing any possible misunderstandings later on.

With this in place, you will be free to enjoy your time at the practice as you develop your competency and career as a GP.

Good luck!

the GPRA team

“Make every bargain clear and plain, that none may afterwards complain.” Greek proverb


contents 1

Your Essential Checklists3 Your Essential Checklist

7 Why Negotiate?

9 What Do Other Registrars Earn and Negotiate? the GPRA benchmarking survey

15 Key Elements You Can Negotiate

27 GPRA’s Tips on Avoiding Common Problems

31 References and Resources GPRA Membership and Resources. www.gpra.org.au

33 In Conclusion

Appendices

35 Appendix A

National Minimum Terms and Conditions for GPT1 and GPT2 Registrars

45 Appendix b Sample Annual Leave Calculations

GPRA060611002

4 More than Money 2011 An initiative of GPRA More than Money 2011 An initiative of GPRA 5

YOUR NEGOTIATING ChECKLIST Work hours See page 16-17

n hours, sessions and locations, educational release time, adminstration time

n on-call and after-hours

n number of patients per hour

Education and supervision See page 17-18

n in-practice teaching

n educational release time

n supervisor obligation

Remuneration See page 19-20

n base salary or percentage of billings plus 9% superannuation (minimum)

n Pay for ordinary hours

n Pay for off-site work including hospital VMo, nursing home and home visits

n Pay for after-hours and on-call work

n on-call percentage = on premises and off premises

n Frequency of billing cycles

n Payment for working on public holidays

n Payment for annual leave

n siPs and PiPs payments (if paid a percentage)

n Any accommodation subsides

n Any other allowances and expenses

Leave See page 21-22

nAnnual leave and method of annual leave calculations

nPersonal/carers leave (includes sick leave)

ncompassionate leave

nstudy leave

nParental leave

Other matters See page 22-24

nemployee or contractor (GPtA and GPt2 will be employee only)

nMedical indemnity insurance

nPersonal safety

nRestrictive covenants

nRenegotiation

ndispute resolution

ntermination of employment

Contract paperwork

ncomplete your written contract and ensure it is signed and dated by you and your employer

This checklist is a summary of key topics that may be covered and documented in your employment contract how to negotiate your employment contract in 7 easy steps

1 Read, research and prepare. Prior to your employment interview, read this GPRA negotiating Guide. You should also read the national Minimum terms and conditions (nMtc) in Appendix A.

2 Get a contract template. some regional training providers have a standard contract template, so ask whether yours does. compare the contract to the checklist. contact GPRA for assistance if your RtP does not have a contract template.

3 think about what you want before your interview. consider what’s really important to you and where you may be willing to compromise. Aim high but know the least you are prepared to walk away with.

4 bring copies of your RtP’s contract template (if they have one), the negotiating checklist on page 4 and the nMtc to your interview. Record the outcomes of the negotiated topics on your contract template.

5 Ask for time before you sign. if you are unsure about any aspect of your contract and would like more thinking time or if you would like to consult your Registrar Liaison officer about any issues, you can ask to take the contract away with you before you sign it.

6 staple a copy of your completed contract to a copy of your letter of appointment and the nMtc. once you have completed the paperwork and you and your employer have signed it, ensure that both you and the practice keep a copy for reference.

7 Relax and enjoy your GP term. once you know everything is properly documented, you’ll be free to enjoy your work at the practice.


2

Why Negotiate?

More than Money 2011 An initiative of GPRA 008 More than Money 2011 An initiative of GPRA

Why should I negotiate an employment contract?General Practice Registrars Australia (GPRA) negotiates the national Minimum terms and conditions* (nMtc) agreement with the national GP supervisors Association (nGPsA) on behalf of GPt1 and GPt2 registrars. (*see Appendix A.)

however, while the nMtc agreement is a great starting point, it’s a goodwill document and it doesn’t act as a contract on its own. it is strongly recommended that you sign an employment contract with your practice that clearly sets out all the elements of your employment.

one reason for this is that there can be confusion over the interpretation of some sections of the nMtc document. in addition, the practice will not necessarily have an in-depth knowledge of the nMtc.

having a written contract between you and your practice ensures clarity between employee and employer, and gives both parties recourse against breaches under contract law.

even if you simply negotiate to agree on the minimum terms, the negotiation process is important in developing a shared understanding of what you have agreed to.

Remember, the nMtc is a statement of the “minimum” terms and conditions and even as a GPt1 and GPt2 registrar you may be offered or may be able to negotiate terms that are better than this minimum.

GPt3 registrars and beyond are not officially covered by the nMtc guidelines, but it re-mains a useful guide. Most registrars at this level

are paid a percentage of their billings and it is essential to understand what can and should be negotiated.

Any conflicts between registrars and practices usually arise because of confusion over what has been agreed rather than deliberate breaches. it’s therefore best to be clear about all aspects of your employment agreement from the outset to avoid any potential problems in the future.

We encourage you to enter the negotiation process with an attitude of goodwill and a willingness to look for a win-win outcome. Remember, negotiation is a two-way street and an aggressive style could harm your relationship with your employer before you have even started.

Who will I be negotiating with?For many registrars, the main contact with a practice is with the supervisor.

however, it is also important for a registrar to have some understanding of the business structure of the practice. this can have implications for the contract negotiations as it is increasingly not the supervisor who has control over the running of the business.

depending on the business structure, you may typically be negotiating with one or more of the following people:

•supervisor – training issues

•Receptionist – work times and days

•Practice Manager – work times, days and financial matters

•business Manager – financial matters

•corporate office – financial matters

3

What Do Other Registrars Earn and Negotiate?

The GPRA Benchmarking Survey


the earning per session average does not differ markedly between general ($276) and rural ($264) pathway registrars, nor between full-time ($270) and part-time ($293) registrars.

there was an appreciable difference between the weekly and sessional earnings between male and female registrars, with males earning a higher amount, as illustrated in the following table.

table b: Average Full time Gross Weekly & sessional earnings – Male versus Female

For ordinary hours, most registrars either earn “a base salary or percentage of billings, whichever is greater” (46%) or they are paid only “a percentage of billings” (33%). Among those who are paid a percentage, the majority (58%) are paid more than the minimum 45%. GPRA believes it is encouraging to see that a registrar earns a higher percentage of billings the further into their training they are. While almost three-quarters of GPt1 registrars are paid 45% (72%), the majority of GPt3 registrars (86%) are being paid at a higher rate.

table c: Percentage of billings Paid – by current term

Furthermore, the majority of those who are paid a percentage of billings (83%) are on a weekly, fortnightly or monthly billing cycle rather than the default three-month cycle. this is a plus for these registrars because a longer billing cycle can decrease earnings, especially when calculating leave pay. A shorter billing cycle – preferably weekly or fortnightly – can work in a registrar’s favour.

table d: Frequency of billing cycle

on average, full-time registrars worked 9.0 sessions each week and there was no significant difference between the number of sessions worked between males (9.2 sessions) and females (8.9 sessions).

When it comes to registrars’ experiences with negotiating their employment conditions, less than one in two registrars (44%) actually engage in negotiation with their practices. however this changes significantly over time with a minority of registrars negotiating in GPt1 (27.7%) and a majority negotiating in GPt3 (56.7%) and extended skills terms (64.9%), as illustrated in the following table.

table e: negotiated current employment contract

interestingly, there were no significant differences in the percentage of registrars who had negotiated their conditions at the gender level

About the GPRA terms and conditions benchmarking surveyin late 2009 and early 2010, GPRA conducted a survey to benchmark the salaries and employment conditions of general practice registrars. there were 435 responses from registrars at all stages of training.

in such a diverse environment as general practice, it is often hard to know how the deal you are being offered measures up to the experiences of others. the findings of this survey can help give you an idea.

but remember, everyone is different and a “good deal” is one that you are happy with.

GPRA’s terms and conditions benchmarking survey Report 2010 can be found in full at www.gpra.org.au/research

A survey summary: As would be logically expected, the further registrars get into their training, the better their employment arrangements and conditions appear to get. the findings indicate that the earning average of a full-time GP registrar in Australia is $274 per session, while earning potential increased from $248.60 in GPt1 to $331.50 in GPt3.

table A: Average Weekly and sessional earnings GP term

All extended skills/ Registrars GPt1 GPt2 GPt3 special skills

Average earning 274.00 248.60 258.80 331.50 325.70 per session

Average weekly 2192.00 1914.00 2148.00 2354.00 2573.00 per session

All Registrars Males Females

Average earning 274.00 287.50 259.70 per session

Average weekly 2192.00 2645.00 2311.00 per session

current term


40% 0.7% 0.0% 0.0% 1.5% 3.3%

45% 41.7% 72.2% 60.7% 12.3% 6.7%

50% 26.6% 19.4% 27.0% 26.2% 23.3%

55% 12.9% 2.8% 7.4% 26.2% 23.3%

60% 12.2% 5.6% 2.5% 23.1% 33.3%

>60% 5.9% 0.0% 2.5% 10.8% 10.0%

All Registrars

Weekly 16.6%

Fortnightly 55.5%

Monthly 10.6%

three Monthly 17.4%

base: Respondents who were paid a percentage of billings

current term


Yes 44.2% 27.7% 38.8% 65.7% 64.9%

support for this (41.9%), significant numbers were unsure (28.6%) or did not agree (29.5%). support for this idea decreased as registrars progressed through training, with only around a third (35.5%) of GPt3 registrars supporting this concept.

table G: Would Like for there to be an nMtc document for GPt3 – by current term

Registrars were also asked what sort of assistance they would find useful in the negotiating process in GPt3 and a few options other than an nMtc-style document (outlined in the following table) were thought to be potentially useful.

table h: usefulness of Resources in negotiating for GPt3 (subsequent term)

Finally, while not the focus of the survey, findings suggested a need for more targeted support of registrars undertaking their GPt1 term, with just 55% of registrars feeling satisfied with their job overall compared with 73% of all respondents.

this may in part be due to low levels of satisfaction with the terms and conditions of their employment (40%) and because so few are able to negotiate better terms. that one in three GPt1 registrar is paid a fixed salary (33%) may be the source of some disgruntlement, so too the fact that around one in three (35%) who are paid a percentage are paid according to a three-monthly billing cycle.


overall, it appears that many registrars are poorly informed about their entitlements with around one in ten registrars (11%) not aware of the nMtc document and only around half (55%) referring to the document when deter-mining their employment arrangements.

there was significant confusion around what types of leave registrars are entitled to, with 27% of respondents unsure if they were able to take study leave, 46% unsure about maternity/paternity leave and 40% who didn’t know about carers leave.

the survey appears to indicate that breaches of the nMtc occur among employers of GP registrars and is of great concern to GPRA. specifically, there are some registrars who are forced or encouraged to work as contractors during GPt1 and GPt2 by their RtP (2%), practice (8%) or their supervisor (5%) and that as high as 15% appear to see more than the maximum recommended four patients per hour.

Also, many registrars indicated not being able to take the mandatory sick leave (7%), annual leave (2%) and carers leave (16%) to which they are entitled. A further 21% do not have a signed paper contract with their current employer.

the survey results suggest that registrars as a whole require greater assistance through the negotiation process. only around one in five registrars (20%) appear to receive assistance from their RtP in negotiating and, when this is provided, it is normally basic verbal advice (56%) and/or through the provision of a contract template. (48%).

Registrars were asked if they would like to have a document, such as the nMtc, to be implemented for GPt3 registrars. While overall responses indicated that there may be

%

Percentage of in-house billings 45.5%normal working hours 40.3%holiday leave 26.0%Percentage of after-hours work 18.8%unpaid leave 16.9%teaching time (eg teaching medical students) 16.9%After-hours 16.2%salary 14.9%study leave 13.0%on-call 12.3%sick leave 10.4%Paid leave 9.7%Pay cycle (eg weekly, fortnightly, monthly) 9.1%Percentage of hospital work 8.4%Access to siP payments 8.4%Access to PiP payments 8.4%Maternity/paternity leave 6.5%super 5.8%Base: Respondents who took part in negotiations for their GPT1 and GPT2 terms

cuRRent teRM

All Registrars GPt1 GPt2 GPt3

Yes 41.9% 44.7% 47.6% 35.5%

no 29.5% 25.5% 23.0% 41.9%

unsure 28.6% 29.8% 29.4% 22.6%

usefulness Very useful of some use

a) negotiating Guidelines Manual 50.2% 39.9%

b) Minimum terms and conditions document 46.9% 38.3%

c) Workshop on negotiating 49.7% 36.5%

d) Recommended contract with guidlines 56.1% 34.9%

or between full-time or part-time registrars. however, general pathway registrars were more likely than rural registrars to have negotiated their employment conditions (49% versus 37%).

With regard to how they found the negotiation process itself, among those registrars who actually negotiated their current employment conditions, most (58%) found it difficult and only around four in ten (39%) felt confident in negotiating the conditions of the term with their employer. this is one area where gender differences were apparent with female registrars considerably more likely to find the process either “somewhat” or “very” difficult (64%) compared to male registrars (45%). similarly, where most male registrars felt confident in negotiating the conditions of their term (59%), just one in three female registrars did so (29%).

Where registrars did engage in negotiation with practices the most commonly negotiated conditions were the percentage of billings paid, normal working hours and holiday leave. the following table illustrates the conditions registrars were able to negotiate on.

table F: Frequency of negotiated conditions


4

Key Elements You Can Negotiate


What elements should I negotiate on?the needs of individual registrars are unique. the needs of practices also differ. While reading this guide, it is worth considering which elements in the agreement are the most important to you and which ones you could accept a compromise on.

being able to compromise on one or more elements that are not vital to you, but helpful to the practice, can put you in a stronger overall negotiating position. being open to understanding issues critical to the practice also builds a more positive working relationship if you end up working with them permanently.

it’s wise to think about the “big picture”. earning a reasonable income is necessary for most of us, but there are considerations beyond money and essentially your years as a registrar are a learning experience. there are many other aspects that should be kept in mind when negotiating a contract.

this may include the availability of training in the areas that interest you, a willingness by the practice to fit in with the days you want to work or the ethos and values of the practice and its people. these will differ from registrar to registrar, but finding a practice that suits you should be highly valued.

Work hoursReference: read nMtc section 4

Discuss the average structure of your weekthis may include start and finish times, scheduled consulting hours including home, hospital and nursing home visits, locations, time for administration, teaching and educational release, and any on-call and after-hours duties.

the nMtc defines ordinary hours as the time between commencing and finishing work each day. ordinary hours for payment purposes are between 8am and 8pm Monday to Friday and 8am and 1pm on saturday. the ordinary hours will be agreed prior to the commencement of the term.

ordinary hours for a full-time registrar are 38 hours per week averaged over four weeks, with no less than 27 hours per week averaged over four weeks of patient contact time.

Remember, the 38-hour week has been designed to include educational release time, in-practice teaching and administration time. Meal breaks and on-call time are not included in ordinary hours.

the educational releases typically don’t occur every week and depending on your RtP you may attend these weekly, fortnightly or even monthly. in these cases the overall time would be averaged over the relevant time period where you may be doing more consulting in certain weeks and more formal education at other times. it is important to ensure that both you and the practice are aware of the educational release requirements from your RtP and that these are factored into the contract.

Part-time hours and conditions apply on a pro rata basis with the exception of teaching and educational release, which is half that of full-time registrars irrespective of the hours worked.

Discuss any on-call and after-hours duties

the nMtc states that where a practice is normally open outside of ordinary hours, the registrar may be rostered to work. the registrar may also be rostered to be on call. these are considered a normal part of general practice.

the nMtc requires that the working arrangements for registrars should be no more onerous than for other GPs at the practice. this means that you shouldn’t be the only one doing all the after-hours work and weekend work. however, if the GPs in the practice usually do after-hours, then there may be an expectation for the registrar to contribute. You should ensure that these expectations are explicit in the contract and that you are comfortable with them.

if working after hours is not something you can commit to due to personal reasons, this must be explicitly included in your contract.

When determining rosters and work hours it is important to recognise the importance of reasonable registrar rostering with consideration for commuting requirements between workplaces (including educational releases). this is detailed in the nMtc (section 16).

Discuss the number of patients per hourit is useful to talk about this with your supervisor. GPt1 registrars may start with two to three patients per hour and increase up the maximum

for GPt1 and GPt2 registrars of four patients per hour as specified in the nMtc. sometimes the patient mix can determine the number of patients. For example, if you are the only female doctor in a busy practice you may get a particular patient mix that impacts on the total number of patients you can see. this is something to keep in mind and discuss with your practice.

Education and supervisionReference: read nMtc

Discuss your areas of interest and those of the practice it is important to define your learning plan and areas of interest upfront, and determine how the people and skills within the practice can assist in meeting your personal learning goals. talking to the practice about your learning plan should pick up any potential issues around the type of patient mix and make certain that your learning needs will be met.


Discuss the nature of your in-practice teaching

it is important to discuss the nature of your in-practice teaching with your supervisor before starting at a practice and where possible document this discussion to ensure there is mutual agreement and understanding on how this would occur.

in-practice teaching can take many forms, such as tutorials with supervisors or others in the practice, supervised procedures, practice educational meetings and corridor teaching. A useful tip is to schedule dedicated teaching first thing in the morning or after lunch to ensure that your time is not compromised by patient consultations running late.

Full-time registrars are entitled to 3 hours per week in GPt1 and 1.5 hours per fortnight in GPt2 of in-practice teaching, or half the full-time allocation for part-time registrars. typically this needs to be quarantined time and not comprised entirely of corridor consultations. different supervisors and registrars have a variety of teaching styles and learning styles. We encourage that this is discussed and mutually agreed.

RemunerationReference: read nMtc section 6

Discuss the basis on which you will be paid

under the nMtc registrars should be paid the minimum base salary or a percentage of billings, whichever is greater, so this should be clarified by your employer and documented in your contract.

Minimum salary for GPT1 and GPT2 registrarsthe minimum annual salary for a full-time registrar is set out in the table below or 45% of billings plus 9% superannuation. For GPt1 and GPt2 most practices will pay the minimum salary set down by the nMtc.

Minimum salary for GPt1 and GPt2 Registrars 2011

note, these are minimum rates only and higher rates can be negotiated. the pay scale is reviewed annually.

Payment by billings for GPT1 and GPT2

higher incomes become possible when 45% of a registrar’s billings for the practice exceeds the nMtc minimum wage. typically, the transition point comes when you are seeing an average of three patients per hour doing eight or more sessions a week. however, other factors such as whether the practice bulk-bills or charges higher private patient rates are also important.

A higher percentage of billings rate also makes a substantial difference to income. 45% of billings plus 9% superannuation is the minimum rate for GPt1 and GPt2 according to the nMtc but some registrars are on 50% of billings or more. this may be negotiable, and having more experience or special skills are good reasons to argue for a higher rate.

Calculate your income online if you would like a rough estimate of what your income based on billings may be, GPRA’s online calculator is a useful tool at www.gpra.org.au/earnings/calculator.

GPT3 and beyond payment basis Registrars at GPt3 and beyond who work in a private practice are usually able to negotiate market rates and are typically paid a percentage of their billings. this would normally be better than the GPt2 minimum rate.

Discuss after-hours and on-call work pay ratesAccording to the nMtc this is a minimum of 55% of gross billings plus 9% superannuation. if this includes hospital-based work, registrars should also receive 55% of any on-call allowances paid by rural hospitals.

Discuss how you will be paid for any additional ordinary hours (overtime)

According to the nMtc this should be 150% of the ordinary time rate or time off in lieu.

Annual salary Weekly salary superannuation

GPt1 or 70000.00 1342.53 Plus 9% equivalent superannuation

GPt2 or 84162.00 1614.15 Plus 9% equivalent superannuation

Discuss your educational release time

Full-time registrars are entitled to be released from the practice for paid educational release time of 3.5 hours per week in GPt1 and 3.5 hours per fortnight in GPt2. in some RtPs you are also entitled to educational release in later terms. the minimum required educational release time should be funded by your practice and this should be included in the contract. some RtPs run extra educational workshops beyond the minimum requirements and the practice is not obliged to fund this time.

Part-time registrars are entitled to educational release equal to half of the time allocated to full-time registrars, irrespective of the hours worked. As a part-time registrar you can choose to attend more sessions in your own time or attend only half of the sessions. some RtPs may mandate this for registrars and this should be discussed with the RtP rather than with the practice.

Discuss your supervisor’s obligationsAccording to the nMtc (section 5) the employer must provide supervision that meets the AGPt guidelines. Mutually agreed supervision must be available at all times for after-hours and on-call work. except in circumstances approved by the colleges, the supervisor or a delegated replacement should be available to attend in person to support the registrar in the event of an emergency.


Discuss the frequency of billing cycles

This is the most important negotiating point for registrars and can have a significant impact on earnings.

if you are being paid a percentage, the frequency of billing cycles can make a difference to your income.

billing cycle frequency is of particular relevance when it comes to calculating pay for annual leave. For example, if you are a GPt1 registrar on a weekly billing cycle and take a week’s annual leave, then in that month you would get the minimum base rate for the week of annual leave and 45% of billings for the remaining weeks. A monthly billing cycle would average your billings over four weeks and you could earn less.

the nMtc minimum is every 13 weeks, however such a long billing cycle is not ideal for registrars and a fortnightly or weekly cycle is generally on a registrar’s “wish list”.

GPRA’s benchmarking survey shows that fewer than 20% of registrars are on a 13-week billing cycle. if you are negotiating for a weekly or fortnightly billing cycle and the practice still wants to use a 13-week billing cycle, it may be useful to tell them that over 80% of registrars are on a billing cycle shorter than 13 weeks.

if, for logistical reasons the practice is unable or unwilling to offer shorter billing cycles then you should try to negotiate a different method of calculating annual leave.

Please refer to the GPRA-recommended annual leave calculation proforma, (Appendix b). to mitigate the impact on salary of a longer billing cycle this proforma of leave calculation should be used. this must be explicitly agreed to and included in your contract at the point of negotiation. A simple reference to the GPRA proforma could be an easy way to ensure that you are paid appropriately.

Discuss financial incentives – PIPs and SIPs these financial incentives are paid by Medicare Australia to achieve certain health outcomes and many registrars are unclear about whether they should receive them. Practice incentive Payments (PiPs) are paid to the practice so individual GPs and GP registrars do not receive them. service incentive Payments (siPs) are paid to the individual GPs or GP registrars performing the service. however, it is common for the payment to be shared between a registrar and GP if the GP supported the registrar or vice versa.

Discuss other allowances and expenses if applicableRural or remote placements may include accommodation or rental subsidies. Your package may also include travel allowances or the reimbursement of certain expenses. these are outside the nMtc and can be negotiated on a case-by-case basis.

Leave Reference: read nMtc section 7

Discuss your leave entitlementsthis includes annual leave, personal/carer’s leave (this covers sick leave), compassionate leave, study leave and parental leave. As an employee you are entitled to the leave arrangements set out under the Fair Work Act and the national employment standards. these are non-negotiable and the practice must offer the legislated minimum. there is, however, discrepancy on how this is calculated.

Discuss the method of annual leave calculation in particular the calculation of how you are paid for your annual leave is a common cause of confusion and conflicts, therefore GPRA would urge you to clarify this with your practice before you commence.

Please refer to the GPRA recommended annual leave calculation proforma (Appendix b).

To mitigate any conflicts this must be agreed and explicitly stated in your contract at the point of negotiation. A simple reference to the GPRA proforma could be an easy way to ensure that you are paid appropriately.

According to the nMtc, you are paid annual leave at the rate of the minimum wage or an average of weekly earnings for ordinary hours since the commencement of employment, whichever is greater.

Discuss your annual leave entitlements and scheduling Registrars are entitled to two weeks annual leave every six months or pro rata equivalent if part-time. this applies whether you are on a base salary or percentage of billings. some practices believe that once you are paid a percentage of billings there is no annual leave entitlement, but this is not the case.

if you would like to take your leave during a peak period (for example, christmas), you should discuss this with your supervisor as early as possible.

Annual leave for contractors if you are a contractor rather than an employee, you will not be paid for leave. GPRA advises that registrars are employees by definition and can only be considered contractors under rare circumstances. You must seek independent legal and taxation advice if you are thinking of working as a contractor as you may not meet the requirements of being recognised as a contractor during the training program.


Discuss study leave there is no automatic entitlement to study leave, however, some practices may allow you to take unpaid leave to prepare for exams. this can be very useful and you should bring it up during negotiations if you are planning to sit exams in the near future.

About paid parental leave

Paid parental leave is not specified within the nMtc agreement. due to the structure of training, with frequent changes of practice, most practices are not willing to enter into negotiations regarding paid parental leave.

however, this is something to keep in mind if you are planning to stay with a practice in

the long term after training. Registrars may be eligible for payments via the federally funded parental leave scheme. For more information, see www.familyassist.gov.au.

GPet allows for parental leave (without pay) within the AGPt training program.

Other mattersEmployee versus contractorReference: read nMtc section 3

some registrars and practices believe there are advantages to being a contractor rather than an employee of the practice. GPRA has sought legal advice on this issue which confirms that the nature of registrars’ work means that registrars should be regarded as employees not contractors until training is completed.

in rare cases you may be eligible to work as a contractor, but you must seek independent legal and taxation advice to ensure you meet the requirements. Work as a contractor should not be attempted at GPt1 or GPt2 level.

broadly, GPRA believes that registrars are more likely to be disadvantaged than advantaged financially in working as a contractor.

For information on the difference between a contractor and an employee, it is recommended that registrars and practices refer to the definitions outlined on the Australian taxation office website www.ato.gov.au. involvement in an apprentice or trainee situation has a significant impact on whether an individual is viewed by the Ato as a contractor or an employee.

Medical indemnity insuranceReference: read nMtc section 12.2

As a registrar, you must hold an appropriate level of medical indemnity insurance for the

work you will be required to carry out. Your prospective employer is entitled to ask you for evidence of this. You must inform them immediately if this insurance is terminated for any reason.

Personal safetyReference: read nMtc section 16

it is the practice’s responsibility to provide a safe working environment for registrars. As employers, practices are liable if they fail to provide such an environment regardless of intent.

similarly, it is the duty of registrars as employees to raise any oh&s issues that they become aware of and to comply with the existing oh&s policy of the practice.

if there is any threat to personal safety this must be raised and discussed immediately and, where possible, put in writing.

depending on the severity of the risk, the registrar may choose to not go to work until the issue is resolved or the practice and registrar may agree to an action plan and timeline to resolve the issue.

GPRA strongly encourages early and transparent discussions on any issues related to personal safety. We also encourage that these discussions should be entered in the right spirit with a genuine regard to safety and not be used to push other agendas.

Geographic restrictions on future employmentRestrictive covenants ban a doctor from practising within a certain geographic area close to the employer practice in the future and are designed to protect the practice’s client base.

GPRA has obtained preliminary legal advice to indicate that restrictive covenants are unlikely to stand up to scrutiny for registrars in the training program since they typically don’t control their placements and are often required to move practices to meet the requirements of training. however, there is no case law on this issue and to get a firm ruling it would need to be tested in a court of law.

GPRA believes that restrictive covenants have no place in a training program and would be very difficult to uphold within the training context. Registrar placements at practices should always be driven by the learning plan and training needs.

To protect registrars from any unnecessary legal advice, GPRA strongly recommends that registrars should not agree to any restrictive covenants. Approaching your RTP and or GPRA for support on this issue can be very powerful if a practice is insisting that such a clause should be included.

RenegotiationReference: read nMtc section 6.1.6

GPRA recommends that you set a date to review your contract with your review of remuneration and pay cycles after three months. there may be the opportunity to negotiate a better deal at that stage if you have been performing well. it’s also a good chance to revisit any elements of the contract that may not be working.

if you like the practice, ask about long-term job prospects. Many practices will be looking for registrars to later permanently join their team. so if you’ve fitted in well, this may be an opportunity to discuss future prospects.


Dispute resolution Reference: read nMtc section 17

disputes happen rarely, but should a dispute arise between you and the practice over the terms and conditions of your employment you should inform your RtP immediately.

each RtP has its own process of dispute resolution. Registrars may also seek advice about resolving the dispute from GPRA via their Registrar Liaison officer.

the nMtc states that during the dispute resolution process, both parties should endeavour to continue working in an appropriate and professional manner.

it is a good idea to agree to a dispute resolution process and timeframes as part of the contract. this should include things such as serving a written notice of dispute by either party and agreeing to a mediation process by nominating the RtP or appropriate individual or organisation as a go-to point in case of a dispute. having a clear process can often hasten the resolution process and provide win-win outcomes.

Termination of employmentReference: read nMtc section 14

employment should not be terminated by the registrar or practice before the completion of the term other than in exceptional circumstances. there should be extensive discussion between the practice, GP supervisor, registrar and RtP before such action is taken.

termination notice periods should be discussed and stated in the employment contract and both parties should adhere to this.

exceptional circumstances where patient or doctor safety is at risk or extenuating personal circumstances may allow for termination without any notice by either party. this should be discussed and legal advice sought as appropriate. Any accrued entitlements must be paid to the registrar at termination.

More talking pointsthe following points are unlikely to be core issues in your employment contract but are common questions that may arise when you start at a new practice.

• Orientation Will the practice conduct an orientation session with me?

• Consulting room Will i share a room or have my own room?

• Equipment Will i need to provide any of my own equipment? (stethoscope, auroscope/ophthalmoscope, ear thermometer, neuro exam kit, doctor’s bag, reference books.)

• Bulk-billing versus private billing What is the bulk-billing versus private billing mix? Which patients are bulk-billed?

• Appointment booking system What is the practice appointment booking system? booked appointments versus walk-ins and emergencies? What about home, hospital and nursing home visits?

• Follow up of test results What is the normal procedure for following up patients’ test results at the practice? What happens with test results that come in after i’ve left the practice?

• Registrar as educator teaching obligations Will i be doing in-practice teaching of medical students or others? is this paid? When will this be required and how often?


5

GPRA’s Tips on Avoiding Common Problems


common issue

no employment contract to fall back on when problems arise.

Annual leave payment miscalculations.

teaching time not protected.

solution|

Make sure a contract is created and discussed before you begin work.if you do not have a contract and have started work, request a contract immediately. Your RtP will usually have a contract template. outlining the contract may assist in smoothing out any current problems and addressing further issues before they arise. however, if problems have already arisen this can be a tense situation. that is why it is always best for both employee and employer to sign off on a contract before employment rather than during employment.

negotiate and agree with the practice on how leave payment will be calculated when you are earning a percentage of billings. Refer to Appendix b to see how this works for you. Please note that this is different and above the national minimum. howerver, GPRA believes that registars can be significantly out of pocket, especially if they are on longer billing cycles. if the practice does not agree to the recom-mended GPRA annual leave calculations, then it is important to request a shorter payment cycle from the start (weekly or fortnightly).

Request that your teaching time is “protected” as per RAcGP/AcRRM teaching standards. ensure that your contract clearly states that this time is included in your salary. it is a good idea to discuss how, when and where this teaching will occur.

teaching time and educational release time not paid.

equitable distribution of work and distribution of work hours.

ensure that your contract clearly states that this time is included in your salary. the minimum salary has been calculated using patient consulting time as 28½-29 patient contact hours, in-practice teaching time as 3 hours, educational release as 3½ hours and administration time as 2½-3 hours per week. in-practice teaching time and educational release should be included in your full-time workload. You can choose to work more than the minimum required 27 hours, however, consider and discuss how this will impact on the in-practice teaching and educational release. GPRA recommends that educational release and in-practice teaching time should be paid at the minimum rate. For registrars earning a percentage of billings this is sometimes not clear and should be discussed, negotiated and explicitly stated in your contract.

there is an expectation of goodwill that the registrar will share the workload with the GPs in the course of the normal running of the practice. the workload of registrars should be no more onerous than that of other GPs.

it is a good idea to discuss and agree on the registrar’s contribution towards on-call, after-hours, home visits, hospital visits and other staff commitments relevant to that practice. Request this to be included in your contract.

there should be adequate and available supervision and support for registrars doing on-call.

Key points to consider :1. the registrar should ideally share the workload.2. the registrar should not be expected to do more than the other GPs’ workload. 3. if the registrar clearly is unable to do certain times requested by the practice, this must be clearly stated and agreed by both parties in a contract at the beginning of the employment period.

Common problems and how to avoid themof all the contract problems referred to GPRA, the following issues tend to occur most regularly. take care of these issues and you will be well on your way to a problem-free employment contract and training term.


6

References and Resources

GPRA Membership and Resourceswww.gpra.org.au


References and resourcesGPRA Membership and Resources www.gpra.org.au

GPRA Benchmarking Survey www.gpra.org.au/negotiating-contracts

GPRA Earnings Calculator www.gpra.org.au/earnings-calculator

AGPT Policies www.agpt.com.au/Policies/Policies/

RACGP Training Standards www.racgp.org.au/vocationaltraining/standards

ACRRM Training Standards www.acrrm.org.au/operational-policies

do you have a great resource to assist with contracts and negotiations?

Why not let GPRA know and share it with other registrars? email us at [email protected].

7

In Conculsion


Ready to sign your contract? Enjoy your GP term!We hope this GPRA negotiating Guide has been helpful and we wish you well for this next step on your general practice career path.

Most registrars find negotiating their GP term employment contracts to be a trouble-free process and their training terms to be an extremely rewarding experience.

if you need more specific, individual advice on negotiating your employment contract, we advise you to talk to:

the Registrar Liaison officer at your RtP – your local link to GPRA.

Appendices

Appendix A National Minimum Terms and Conditions for GPT 1 and GPT 2 Registrars

This is the goodwill document negotiated on behalf of registrars by GPRA with the National GP Supervisors’ Association (NGPSA). GPRA recommends you read it before your interview. Note: The NMTC applies to GPT1 and GPT2 registrars but it is also a valuable reference document for GPT3 and beyond.


1. Purpose and Application

1.1 this agreement is operative from the commencement of the 2011 GP training year and is intended for use throughout the Australian General Practice training Program (“AGPtP”) and supercedes any previous agreement. these minimum terms and conditions apply, by agreement between General Practice Registrars Australia (“GPRA”) and the national General Practice supervisors’ Association (“nGPsA”), to all GP Registrars engaged in GPt 1 and GPt 2 who are not covered by the Medical Practitioners Award 2010 or any other applicable award.

1.2 these minimum terms and conditions will be reviewed and updated nationally by three representatives each of the GPRA and nGPsA in July 2012, and every two years thereafter. the Australian Medical Association Ltd (“AMA”) agrees to notify the GPRA and nGPsA when the review is due and to assist them in reaching agreement on the terms of the update.

1.3 these minimum terms and conditions are intended to establish a fair and reasonable basis of employment for registrars in order to support an appropriate educational environment.

1.4 this agreement continues in force, and applies to all registrars and supervising practices, until agreement is reached on the terms of the next update.

1.5 this agreement aims to reflect and uphold the standards of General Practice training.

1.6 For the purpose of this agreement:

“AcRRM” refers to the Australian college of Rural and Remote Medicine;

“AGPt” refers to Australian General Practice training;

“AMA” refers to the Australian Medical Association;

“college” refers to RAcGP and AcRRM;

“GPRA” refers to the General Practice Registrars Association;

“GPt 1” refers to the first six-month placement in a general practice or equivalent setting within the AGPtP;

“GPt 2” refers to the second six-month placement in a general practice or equivalent setting within the AGPtP;

“nGPsA” refers to the national General Practice supervisors Association;

“practice” refers to the training general practice employing the registrar ;

“RAcGP” refers to the Royal Australian college of General Practitioners;

“registrar” refers to the GP registrar on the AGPt program;

“RtP” refers to the registrars’ Regional training Provider ;

“supervisor” refers to a GP accredited by a college as a supervisor

2. statement of Goodwill

the GPRA and nGPsA acknowledge that a mutual attitude of goodwill must exist for the registrar, the supervisor and the practice to extract maximum benefit from this term of training and employment. the GPRA and nGPsA agree that the parties they represent will make all reasonable efforts to work and learn together in a spirit of mutual trust and goodwill. Additionally, they acknowledge that

this agreement is not comprehensive and that every effort will be made to reasonably discuss and resolve other difficulties as they arise.

this agreement is based on the relevant AGPt and college policies in place as at 1 July 2010. the nGPsA and the GPRA agree to discuss any significant changes to AGPt and college polices that may affect the operation of this agreement.

the parties agree that they will use their best endeavors to arrange an equitable distribution of work in the practice with the intent that the registrar obtains training across the spectrum of general practice and shares the patient workload with other doctors in the practice.

3. Nature of Employment

3.1 Registrars engaged in GPt 1 and GPt 2 are employed in the capacity of an employee and a employment agreement will be negotiated between the practice and the registrar that at least satisfies the minimum terms and conditions contained in, and using the framework defined in, this agreement.

3.1.1 For information on the difference between a contractor and an employee, it is recommended that registrars and practices refer to the definitions outlined on the Australian taxation office website. http://www.ato.gov.au/businesses/content.asp?doc=/content/00095062.htm involvement in an apprentice or trainee situation has a significant impact on whether an individual is viewed by the Ato as a contractor or an employee.

3.2 A copy of the employment contract (signed by the employer and the registrar) must be exchanged prior to commencement of his/her employment in a training position.

3.3 An Australian defence Force Registrar may be bound by employment contracts that differ from the requirements outlined in 3.1 above.

4. Work hours

4.1 ordinary hours

4.1.1 the ordinary hours of the registrar are calculated as the time between commencing and finishing work each day. ordinary hours do not include on-call time and meal breaks. ordinary hours shall be worked in periods of not less than 3 hours and no greater than 12 hours on any one day. ordinary hours for payment purposes are between 8am and 8pm Monday to Friday and 8am and 1pm on saturday. the ordinary hours will be agreed prior to the commencement of the term. ordinary hours include:

a) normal general practice activities such as:

• scheduled consulting time (whether seeing patients or not)

• home, hospital and nursing home visits including travel time

• Administrative time (e.g. writing notes, telephone calls, reports)

b) practice based teaching time; and

c) educational release time.

4.1.2 if the registrar is employed on a full time basis, the ordinary hours of the registrar shall:

a) be 38 hours per week averaged over 4 weeks, of which not less than 27 hours per week averaged over 4 weeks shall be scheduled patient contact time;

b) be worked over at least four days per week averaged over 4 weeks;


4.1.3 if the registrar is employed on a part-time basis, all the conditions in this agreement apply on a pro rata basis with the exception of educational release and teaching time which, for part-time training, is equivalent to half that for full-time training, irrespective of the actual numbers of hours worked each week. the ordinary hours of a part time registrar shall:

a) be no less than 10.5 hours per week averaged over 4 weeks of which not less than 9 hours must be scheduled patient contact time; and

b) be worked over not less than 2 days per week.

4.2 Workload

during both the GPt 1 and GPt 2 term, there should be a maximum on average of four patients per hour. GPRA and nGPsA realise that in times of special circumstance, such as emergencies, staff illness and outbreaks of illness this workload may vary.

4.3 After hours and on call

4.3.1 Where a practice is normally open outside of ordinary hours, the registrar may be rostered to work. this is considered to be a normal part of general practice. these arrangements shall be no more onerous than those of other full time doctors in the practice (pro rata for part-time registrars).

4.3.2 on call

the registrar may be rostered to be on call. this is considered to be a normal part of general practice. these arrangements shall be no more onerous than those of other full time doctors in the practice (pro rata for part-time registrars).

5. Supervision

5.1 the employer shall provide supervision in accordance with AGPt guidelines.

5.2 Appropriate, mutually agreed supervision must be available at all times for after hours and on-call work.

5.3 except in circumstances approved by the colleges the supervisor or his/her delegate should be available to attend in person, should the registrar request this in the event of an emergency.

6. Remuneration

6.1 Pay for ordinary hours

6.1.1 the following salaries are based on a full-time, 38 hour week.

6.1.2 Gross billings include all fees generated by the registrar from all sources. this includes all fees relating to the registrar’s provider number including service incentive Payments but excluding Practice incentive Payments.

6.1.3 Part-time salaries during GPt1 and GPt 2 shall be calculated on a pro rata basis.

6.1.4 GPt 1

a) the minimum annual salary for a full time registrar is $70,000 ($1,342.53/ week), plus 9% superannuation;

or

b) 45% of in hours gross billings, plus 9% superannuation, calculated over a 3 monthly cycle inclusive of leave taken,

whichever is the greater.

(the minimum salary has been calculated using patient consulting time as 28½ - 29 hours, teaching time as 3 hours, educational release as 3½ hours and administration time as 2½ - 3

hours (per week). Administration, including report writing, is expected to occur during ordinary hours.)

6.1.5 GPT 2

a) the minimum annual salary for a full time registrar is $84,162($1,614.15/ week), plus 9% superannuation;

or

b) 45% of in hours gross billings, plus 9% superannuation, calculated over a 3 monthly cycle inclusive of leave taken,

whichever is the greater.

6.1.6 A review of remuneration and pay cycles should occur after 3 months of employment.

6.1.7 For the purposes of 6.1.4 and 6.1.5:

a) the fortnightly rate of pay will be ascertained by applying the following formula:

Fortnightly Rate of Pay = Annual salary 26.07

b) the hourly rate of pay will be ascertained by applying the following formula:

hourly Rate of Pay= Fortnightly Rate of Pay

76

6.1.8 the minimum salaries of $70,000 and $84,162 shall apply from the start of the 2011 training year.

6.1.9 the salaries prescribed in this agreement will be reviewed at the end of each calendar year and adjusted upwards in line with movements in the cMbs, VR Level b consultation item. both parties shall accept the determination of the AMA with respect to the amount of indexation. the new salaries

will become applicable in the new training year immediately following this.

6.2 Pay for additional ordinary hours

overtime is calculated on weekly hours (excluding on call work) in excess of 38 averaged over a 4-week cycle, or in excess of ordinary scheduled hours for part-time registrars. Registrars shall have the right to decline practice requests to work additional ordinary hours without penalty or disadvantage. by agreement overtime can be:

a) taken as time off in lieu at the ordinary time rate (ie an hour for each hour worked), at a time agreed between registrar and supervisor, but within one month).

or

b) paid at 150% of the ordinary time rate, plus 9% superannuation.

6.3 Pay for after hours and on call

6.3.1 For after hours and on-call work at the practice or off site, the registrar will be paid a minimum 55% of gross billings, plus 9% superannuation.

6.3.2 Where after hours and on-call involves hospital – based work the registrar will be paid a minimum 55% of gross billings, plus superannuation, plus 55% of the on-call allowances paid by rural hospitals where applicable.

6.4 Time of Payment

6.4.1 A registrar’s salary for all work undertaken in connection with the practice shall be calculated, according to billings, and paid at least fortnightly and will not be delayed pending payment for consultations (i.e. pay


is calculated in relation to billings and not receipts).

6.4.2 Payment for hospital work will be paid in accordance with the hospital billing cycle.

6.4.3 the practice must provide at registrar request access and explanation of their patient billing information.

7. Leave

7.1 Annual Leave

7.1.1 A registrar shall be paid no less than two weeks annual leave per 6 months full-time period (pro rata for a part-time registrar). Any unused leave shall be paid out on termination of employment. there is no leave loading entitlement.

7.1.2 Annual leave will be paid at the registrar’s current relevant base weekly wage or an average of weekly earnings for ordinary hours calculated since the commencement of term, whichever is the greater. examples of how leave payments are to be calculated are set out in the schedule

7.2 Personal/carer’s Leave

7.2.1 Personal/carer’s leave means leave taken due to personal illness or injury (sick leave) or to provide care or support for a member of the registrar’s immediate family or household who requires care or support due to personal illness or injury, or an unexpected emergency (carer’s leave).

7.2.2 unless otherwise specified under legislation, paid personal/carers leave for a full-time registrar is accrued on the basis of 1/26 of the number of ordinary hours worked during the previous completed four week period. For a full time registrar working 38 hours per week,

this will amount to 38 hours (ie, 5 days) over a 26-week term.

7.2.3 A full-time registrar working 38 hours per week will be entitled to an advance of 38 hours paid personal/carer’s leave for each 6 months full-time period of employment on commencement of the term. For a part-time registrar this shall be calculated on a pro rata basis.

7.2.4 in the event the registrar has taken unaccrued personal/carer’s leave and terminates her/his employment, the practice is entitled to withhold an amount equivalent to those hours taken as unaccrued sick leave.

7.2.5 the calculation of pay for personal/carer’s leave shall not be on a percentage of billings, but each day off sick, shall be paid as follows:

a) GPt 1: $1,342.53/38hours = $35.33 per hour

b) GPt 2: $1,614.15/38hours = $42.47 per hour

7.2.6 Personal/carers leave is calculated on a pro rata basis for part-time registrars using the formula prescribed in 7.2.2 above.

7.2.7 A registrar is entitled to an additional two days of unpaid carer’s leave on each occasion that a member of the Registrar’s immediate family or household requires care and support due to illness, injury, or an unexpected emergency.

7.2.8 unpaid carer’s leave can only be taken once all paid personal/carer’s leave entitlements have been used.

7.3 compassionate Leave

A registrar shall be entitled to up to two days paid compassionate leave, which can be taken upon the death of a member of the registrar’s

immediate family or household, or to spend time with a seriously ill, injured or dying person who is a member of the registrar’s immediate family or household.

compassionate leave taken shall be paid at the rate of $35.33 per hour for GPt1 and $42.47 per hour for GPt2.

7.4 definition of immediate family or household

For the purpose of 7.2 and 7.3 above, immediate family household means the registrar’s spouse (including de facto spouse, former spouse, or former de facto spouses), child, parent, grandparent, grandchild or sibling. in addition, immediate family includes the child, parent, grandparent, grandchild or sibling of the registrar’s current or former spouse (including de facto spouses).

7.5 Parental Leave

Parental leave requirements are dealt with extensively under Federal, state and territory legislation. Arrangements for parental leave, which includes maternity, paternity and adoption leave, should be discussed between the registrar and the employer having regard to the application legislation.

7.6 Study Leave

there is no automatic entitlement to study leave. Registrars who consider they may require such leave are encouraged to discuss with their practice and include such considerations in their employment agreement. Registrars shall be aware that such leave may have implications on training time and progress through the program.

8. Public holidays

8.1 A Registrar who normally works ordinary hours on the day of the week on which a public holiday falls is entitled to that public holiday as paid leave (i.e. that day is part of the registrar’s ordinary hours of work for that week).

8.2 if a registrar works on a public holiday:

• in a practice that is open for normal consultations, then the registrar will receive their normal pay and a paid day off in lieu (or half day, if only one session was worked on the holiday)

or

150% of their usual hourly rate or 55% of their billings, whichever is the greater. in this instance the registrar is not to be entitle to time off in lieu.

• in an on-call capacity for a practice which is closed for normal consultations, then the registrar will receive their normal hourly rate for their usual rostered hours PLus 55% of their billings for that day. in this instance the registrar is not entitled to a paid day off in lieu.

8.3 the allocation of public holiday rostering shall be no more onerous than that of other doctors in the practice.

9. Superannuation and Workers’ Compensation

the practice will observe the requirements of superannuation law and will ensure it has insurance to cover workers’ compensation for the registrar.


10. Expenses

10.1 travel

the registrar will be reimbursed by the practice for expenses incurred by the registrar in the use of the registrar’s motor vehicle for work purposes during ordinary hours and on call work. Reimbursement shall be at the standard Australian taxation office rates. to substantiate a claim for reimbursement, the registrar will keep a travel diary.

10.2 Relocation expenses

unless otherwise agreed, the practice is under no obligation to meet a registrar’s relocation expenses. A registrar undertaking a rural term may be eligible for subsidised relocation expenses from the RtP.

11. Accommodation

11.1 the GPRA and nGPsA agree that neither the practice nor the registrar should be financially disadvantaged in supporting a registrar’s accommodation.

11.2. Any RtP-provided accommodation subsidy, where applicable, shall be distributed appropriately to either the registrar or the practice depending on who incurs the cost of provision of accommodation.

11.3 if a registrar is undertaking a GP term in a rural area, the practice will:

11.3.1 assist the registrar to find suitable accommodation to suit their needs (which is self-contained, fully furnished with kitchen facilities) and is in accordance with the standard approved by GPet; and

11.3.2 support the registrar in accordance with their RtP terms and conditions.

11.4 the registrar will be responsible for payment of water, gas, electricity and private phone usage.

12 Registrar Obligations

12.1 Medical Registration

A registrar employed in accordance with this agreement must have a current registration with the Medical board of Australia. in the event that registration is withdrawn or conditions are imposed upon it, the registrar is required to notify the employer as soon as practicable.

12.2 indemnity

12.2.1 during the term of employment, the registrar will hold professional indemnity insurance in respect of the work contemplated by this agreement. the registrar will, if requested by the employer, produce evidence of medical indemnity. in the event that professional indemnity insurance is withdrawn or altered, the registrar must notify the employer as soon as practicable.

12.2.2 the registrar authorises the practice to make inquiries of the registrar’s medical insurer to verify membership or level of insurance, as the case may be.

12.3 Release of data

12.3.1 Practice incentive Program: the registrar shall, if requested by the practice, consent to the release of relevant Medicare Australia data.

12.3.2 the Registrar will notify the supervisor as to whether or not they have consented to the release of their Medicare Australia data.

12.4 confidential information

during the registrar’s term of employment and after it has ceased, the registrar will not use

or divulge any information confidential to the practice and its patients.

12.5 incorrect billings

As the billing doctor is responsible for any incorrect billing practices, it is recommended that registrars review their list of patient billings on a regular basis to protect themselves from inadvertent breaches of Medicare legislation.

12.6 Passing on billings

the Registrar is obliged to pass to the practice all billings received by him or her, for work performed under the registrar’s provider number at the practice.

13. Practice Obligations

13.1 Practices will maintain records for the time periods required under state and territory law and make those records available to the registrar after leaving the practice in the event the registrar is required to respond to a complaint, claim or Professional services Review.

13.2 Practices will pass on to the registrar during the time at the practice and afterwards the percentage of service incentive Payments accruable to them.

13.3 Practices will provide the registrar with billing information.

14 Termination of Employment

14.1 employment should not be terminated by the registrar or practice before the completion of the term, other than in exceptional circumstances and only where there has been extensive discussion between the practice/GP supervisor, the registrar and the RtP.

14.2 in all other circumstances appropriate notice of termination should be given and the period of notice should be determined by mutual consent (in any event not less than 2 weeks unless by mutual consent).

14.3 Any accrued entitlements, including annual leave must be paid to the registrar at termination. superannuation contributions must be made to the relevant fund.

15. Future Employment

15.1 An agreement may be reached between the registrar and the employer regarding geographic restrictions on where the registrar may practise on leaving the training post, provided that it does not unreasonably interfere with the completion of the registrar’s training or cause unreasonable hardship for the registrar.

15.2 the supervisor, employer, practice and the registrar acknowledge that a restrictive covenant must be reasonable and should not be wider than is reasonably necessary to protect the employer’s interests when judged in terms of the duration and area of its coverage and the activities restrained.

16 Safety and Security

16.1 the GPRA and nGPsA recognise that the personal safety of a registrar, especially working alone, on home visits or in the surgery after hours is an issue to be addressed when making after hours and on-call arrangements.

16.2 Key areas to be addressed include:

• Reliabletelecommunicationcontactforany after hours, or home visits

• Reasonable registrar rostering, with consideration for commuting


requirements between workplaces (including educational releases)

• the practice is required to undertake a risk assessment and appropriate risk minimisation strategies in relation to the registrar’s work environment and discuss this with the registrar.

16.3 the GPRA and nGPsA agree that if a registrar feels unsafe in a particular environment that this issue shall be addressed by the practice. if the registrar continues to feel unsafe then the registrar may invoke the dispute resolution process outlined in clause 17.

17. Dispute Resolution

17.1 Where a dispute arises between the registrar and the practice over the terms and conditions of employment, the parties should utilise the dispute resolution process adopted by the RtP. during the dispute resolution process, both parties shall endeavour to continue to work in an appropriate and professional manner.

17.2 notwithstanding 17.1 above, the opportunity for individuals to refer via their Registrar Liaison officer or supervisor Liaison officer to the nGPsA/GPRA for advice on terms and conditions disputes remains available as an option.

Agreed and signed by the parties, to come into effect from the commencement of the 2011 GP training year.

ThE SChEDULEexamples of calculating payment for leave taken.

example 1

GPt 1 receiving weekly salary of $1,342.53 takes 2 weeks leave during term.

For the period of leave the GPt 1 is paid $1,342.53 x 2 = $2,685.06

example 2

GPt1 receiving 45% of in-hours gross billings inclusive of leave taken, takes 2 weeks leave during the 3 month cycle

their billings over the 3 month cycle were $50,000.

the GPt1 payments calculated over the 13 week cycle will be 45% of $50,000 i.e. $22,500. this is an average of $1730.76 for each week, whether it be worked or taken as leave.

example 3

GPt1 receiving 45% of in-hours billings inclusive of leave taken, takes no leave during term, but then takes 2 weeks leave after term is completed.

their billings over each 3 month cycle were $50,000.

step 1 calculate the gross billings per 3 month cycle, i.e. $50,000.

step 2 calculate 45% of the gross billings, i.e. 45% of $50,000 = $22,500.

step 3 convert this figure to a weekly figure, i.e. $22,500 divided by 13 = $1,730.76.

step 4 Pay 2 weeks leave at this rate, i.e. $1,730 x 2 = $3,461.52

Appendix B Sample Annual Leave Calculations

Calculating payment for annual leave can be a source of confusion. These examples may help to provide some clarity.


the nMtc 2011 lays down the minimum standards and also includes worked examples for annual leave calculation. this is a minimum document and practices are not obliged to offer any extra incentives. however, GPRA believes that the nMtc method of leave calculation disadvantages registrars on a longer billing cycle. A more equitable method of calculating leave is outlined below. Whilst this method does not create any significant material difference to registrars or practices on weekly or fortnightly billing cycle it does have an impact for registrars on a 3 monthly billing cycle (83% of registrars within the training program are on a weekly, fortnightly, or monthly pay cycle in comparison to the 17% of registrars on a 3 month billing cycle).

Practices must pay their employees annual leave and superannuation on top of their salary whether they are being paid a percentage of billings or a minimum wage. This is in line with the Fair Works Act.

According to nMtc 7.1.2, annual leave will be paid at the registrar’s current relevant base weekly wage or an average of weekly earnings for ordinary hours calculated since the commencement of term, whichever is the greater.

Let’s look at the options that Registrar dr Jo Lim bloggs has for payment for her annual leave.

According to the nMtc 2011: GPt1Minimum Annual salary= $70,000 GPt1 Minimum weekly rate (MWR)= $1,342.53

GPt2 Minimum Annual salary = $84,162 GPt2 Minimum weekly rate (MWR) = $1,614.15

For the purposes of convenience, let’s assume that our dr Jo Lim bloggs is a GPt2 Registrar.

t%billings = total billings x percentage as determined by registrar contract – for calculating weekly pay oh%billings = ordinary hours billings x percentage as determined by registrar contract – for calculating leave pay

Week 1 2 3 4 5 6 7 8 9 10 11 12

Week 1 2 3 4 5 6 7 8 9 10 11 12 13

t% billings A B C D E F G H I J K L M

oh%billings a b c d e f g h i j k l m

Fortnight 1 2 3 4 5 6 7

Month 1 2 3

3 month 1

Week 1 2 3 4 5 6 7 8 9 10 11 12 13

t% billings 1500.00 1500.00 1600.00 1700.00 1800.00 1900.00 1500.00 1900.00 1900.00 1900.00 1900.00 2000.00 2000.00

oh%billings 1500.00 1500.00 1600.00 1700.00 1800.00 1900.00 1500.00 1900.00 1900.00 1900.00 1900.00 2000.00 2000.00

Fortnight 1 2 3 4 5 6 7

Month 1 2 3

3 month 1

Scenario A. dr Jo Lim bloggs works the entire 13 weeks without taking leave.

on departing the practice, dr Jo is entitled to be paid out two weeks of leave. the amount is two weeks value of either the minimum weekly rate (MWR) for GPt2 registrars, or dr Jo’s average weekly earnings for normal hours over the whole term, whichever is greater.

because she has not taken annual leave, the billing calculations are not affected by any annual leave.

total % billings (A+b+c+d+e+F+G+h+i+J+K+L+M) + 1 week of the averaged weekly billings ($1,776.92) = $24,876.92

or

MWR x 13 weeks ($20,983.95) + MWR x 1 week annual leave ($1,614.15) = 17,452.89 According to the nMtc, dr Jo Lim bloggs would receive in total $24,876.92

it wouldn’t matter when or how dr Jo was paid – weekly, fortnightly, monthly, 3 monthly – she would still receive the same amount.

sometimes life could be this easy...

But what if Dr Jo Lim Bloggs was to take a family holiday to be a part of a best friend’s wedding overseas in the middle of the term?

dr Jo Lim bloggs annual leave would then be calculated in her billing cycle. depending when she is paid, there would be some slight changes in the final amounts.

dr Jo Lim bloggs takes two weeks of annual leave over the 8th and 9th week in the GPt2 term.

*note: for simplicity, we have assumed there are no after hours billings, so will be working from the oh% billings.

%billings 3 months with no holidays for weeks Vs Minimum What is total at end worked Vs Weekly Rate Greater of 13 weeks

total for 13 weeks 23100.00 20983.95 % 23100.00

Annual leave not taken (1 week entitled) 1776.92 1614.15 % 1776.92

total 24876.92

Week 1 2 3 4 5 6 7 8 9 10 11 12 13

t% billings A B C D E F G leave leave J K L M

oh%billings a b c d e f g leave leave j k l m

Fortnight 1 2 3 4 5 6 7

Month 1 2 3

3 month 1

Week 1 2 3 4 5 6 7 8 9 10 11 12 13

t% billings 1500.00 1500.00 1600.00 1700.00 1800.00 1900.00 1500.00 leave leave 1900.00 1900.00 2000.00 2000.00

oh%billings 1500.00 1500.00 1600.00 1700.00 1800.00 1900.00 1500.00 leave leave 1900.00 1900.00 2000.00 2000.00

Fortnight 1 2 3 4 5 6 7

Month 1 2 3

3 month 1

Scenario B.

*in this case, with reference to the table above:

it is assumed that dr Jo Lim bloggs will work a following 13 weeks without annual leave.

dr Jo Lim bloggs is to be paid the greater of the %billings or the MWR for the weeks she worked PLus leave taken. she has earned more through the billings.

As she has not yet been paid at the point when she took leave, in this instance, her holidays will be paid the MWR. (note: dr Jo Lim’s annual leave payment would be different if she took her holiday in the next 3 months)

total oh% billings (a+b+c+d+e+f+g+j+k+l+m = $19,300) + 2 weeks at MWR for annual leave ($3,228.30) = $22,528.30

in accordance with the nMtc, dr Jo Lim bloggs would receive in total $22,528.30

Scenario C. dr Jo Lim bloggs is paid monthly.

Month 1.

dr Jo should be paid the greater of (A+b+c+d) or (MWR x 4). dr Jo Lim bloggs is paid the MWR of $6,456.60 for the first month.

Month 2.

For month 2, Registrar b should be paid the greater of (e+F+G=$5,200) or (MWR x 3=$4,842.45) PLus one week of annual leave.

to calculate annual leave, dr Jo Lim bloggs is entitled to leave pay at either the MWR for GPt2 registrars, or dr Jo’s average weekly earnings (not to be confused with billings) for normal hours calculated since the commencement of term (weeks 1 to 7) inclusive, whichever is greater.


As the average weekly earnings are higher than the MWR, dr Jo’s receives $1,665.00 for annual leave.

dr Jo Lim bloggs is paid $6,865.00 for the second month.

Month 3.

similar to Month 2, dr Jo Lim bloggs should be paid the greater of (J+K+L+M) or (MWR x 4) in addition to one week of annual leave pay as calculated above.

to calculate annual leave, dr Jo Lim bloggs is entitled to leave pay at either the MWR for GPt2 registrars, or dr Jo’s average weekly earnings (not to be confused with billings) for normal hours calculated since the commencement of term (weeks 1 to 8) inclusive, whichever is greater.

As the average weekly earnings are higher than the MWR, dr Jo’s receives $1,665.00 for annual leave.

dr Jo Lim bloggs is paid $9,465.00 for the third month.

in accordance with the nMtc, dr Jo Lim bloggs would receive in total $22,786.60

Scenario D dr Jo Lim bloggs is paid fortnightly.

Fortnights 1-3.

dr Jo Lim bloggs is paid the greater of the total% billings or MWR for each fortnight. no annual leave was taken.

Fortnights 4 and 5.

Fortnights 4 and 5 billings should be calculated on the one week worked and compared to the weekly minimum rate for GPt2 registrars.

the greater of these amounts is added to the calculated rate for one week leave to give the fortnightly pay amount.

For fortnight 4, Registrar b should be paid the greater of G or the MWR in addition to one week of annual leave pay.

%billings plus any 3 monthly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken (MWR) payment cycle

Month 1-3 19300.00 17755.65 % 3228.30 22528.30

sub total 19300.00 17755.65 % 3228.30

total (Greater + annual leave) 22528.30

%billings plus any Monthly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken payment cycle

Month 1 6300.00 6456.60 MWR 0 6456.60

Month 2 5200.00 4842.45 % 1665.00 6865.00

Month 3 7800.00 6456.60 % 1665.00 9465.00

sub total 19300.00 17755.65 3330.00


%billings plus any Fortnightly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken payment cycle

Fortnight 1 3000.00 3228.30 MWR 0 3228.30

Fortnight 2 3300.00 3228.30 % 0 3300.00

Fortnight 3 3700.00 3228.30 % 0 3700.00

Fortnight 4 1500.00 1614.15 MWR 1691.78 3305.93

Fortnight 5 1900.00 1614.15 MWR 1691.78 3591.78

Fortnight 6 3900.00 3228.30 % 0 3900.00

Fortnight 7 2000.00 17755.65 % 0 2000.00

subtotal 19300.00 17755.65 3383.5



to calculate earnings for the week on annual leave, dr Jo Lim bloggs is entitled to leave pay at either the MWR ($1,614.15), or dr Jo’s average weekly earnings (not to be confused with billings) for normal hours calculated since the commencement of term (weeks 1 to 7 = $1,691.78) inclusive, whichever is greater.

For fortnight 5, Registrar b should be paid the greater of J or the MWR in addition to one week of annual leave pay as calculated above.

to calculate payment for the week on annual leave, dr Jo Lim bloggs is entitled to leave pay at either the MWR for GPt2 registrars, or her average weekly earnings (not to be confused with billings) for normal hours calculated since the commencement of term (weeks 1 to 8 = $1,691.78) inclusive, whichever is greater.

As the average weekly earnings are higher than the MWR, she receives $1,665.00 for annual leave.

Fortnights 6-7.

dr Jo Lim bloggs is paid the greater of the total% billings or MWR for each fortnight. no annual leave was taken.

in accordance with the nMtc, dr Jo Lim bloggs would receive in total $23,026.01.

these examples demonstrate the variation of a registrar’s income depending on the method used for calculating their income.

In Summary...if dr Jo Lim bloggs did not take a holdiay

with a holiday in week 8&9

with holiday in week 8&9



%billings 3 months with no holidays for weeks Vs Minimum What is total at end worked Vs Weekly Rate Greater of 13 weeks

total for 13 weeks 23100.00 20983.95 % 23100.00

Annual leave not taken (1 week entitled) 1776.92 1614.15 % 1776.92

total 24876.92

%billings plus any 3 monthly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken (MWR) payment cycle

Month 1-3 19300.00 17755.65 % 3228.30 22528.30

sub total 19300.00 17755.65 % 3228.30


%billings plus any Monthly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken payment cycle

Month 1 6300.00 6456.60 MWR 0 6456.60

Month 2 5200.00 4842.45 % 1665.00 6865.00

Month 3 7800.00 6456.60 % 1665.00 9465.00

subtotal earnings 19300.00 17755.65 3330.00


%billings plus any Fortnightly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken payment cycle

Fortnight 1 3000.00 3228.30 MWR 0 3228.30

Fortnight 2 3300.00 3228.30 % 0 3300.00

Fortnight 3 3700.00 3228.30 % 0 3700.00

Fortnight 4 1500.00 1614.15 MWR 1691.78 3305.93

Fortnight 5 1900.00 1614.15 MWR 1691.78 3591.78

Fortnight 6 3900.00 3228.30 % 0 3900.00

Fortnight 7 2000.00 17755.65 % 0 2000.00



%billings plus any Weekly cycle for weeks Vs Minimum What is annual leave total per worked Weekly Rate greater taken payment cycle

Week 1 1500.00 1614.15 MWR 0 1614.15

Week 2 1500.00 1614.15 MWR 0 1614.15

Week 3 1600.00 1614.15 MWR 0 1614.15

Week 4 1700.00 1614.15 % 0 1700.00

Week 5 1800.00 1614.15 % 0 1800.00

Week 6 1900.00 1614.15 % 0 1900.00

Week 7 1500.00 1614.15 MWR 0 1614.15

Week 8 0 0 MWR 1693.80 1693.80

Week 9 0 0 MWR 1693.80 1693.80

Week 10 1900.00 1614.15 % 0 1900.00

Week 11 1900.00 1614.15 % 0 1900.00

Week 12 2000.00 1614.15 % 0 2000.00

Week 13 2000.00 1614.15 % 0 2000.00



General Practice Registrars Australiat: 1300 131 198W: www.gpra.org.aue: [email protected]

more than money 2012

Documents

n hours

percentage n

annual leave n sips

adminstration time n

ordinary hours n

superannuation minimum

home visits n

n base salary