A study examining the practice patterns of overseas doctors working in Australia has shown that they work longer hours, prescribe more drugs, and order more tests than their counterparts who trained in Australia.
Australia relies heavily on medical graduates from overseas, said the study's lead author, Clare Bayram, from Sydney University's Family Medicine Research Centre. They make up 25% of the total workforce of doctors, but information on how they practise in the Australian setting is virtually non-existent, she said.
She and her colleagues compared 89 overseas trained doctors who were enrolled in a specific training programme with 1032 fellows of the Royal Australasian College of General Practitioners (Australian Health Review 2007;31:441-8). Each participant provided the details of 100 encounters with patients.
“We found that [overseas trained doctors] were significantly younger, had spent fewer years in general practice, worked more sessions per week, and were more likely to work in smaller practices than Australian trained doctors,” Ms Bayram said.
She said that these results weren't surprising, given that many newly arrived doctors from overseas work in regional centres and remote parts of Australia. The overseas doctors were also significantly more likely to see younger patients and Aboriginal patients.
A more surprising finding came when the researchers looked at the treatment patterns of the two groups. Doctors who had trained overseas were more likely to prescribe drugs, to offer clinical and procedural treatments, and to refer patients to allied health professionals and hospitals. They were also more likely to order pathology and imaging tests.
Those differences in treatment patterns remained even when the researchers adjusted the results for mix of patients and the age, sex, and location of the doctor, she said. “There's such a large difference in the prescribing rate that it can't be accounted for by the characteristics of the patients they're seeing.”
Overseas medical graduates are currently high on the political agenda in Australia. After the case of the Queensland based doctor Mohamed Haneef, who was accused of having links to the 30 June terrorist car bombing of Glasgow Airport, the country's immigration minister this week ordered that all overseas trained doctors undergo security checks.
The study's results show that doctors from overseas need more support, said Rosanna Capolingua, president of the Australian Medical Association. “They play a very important role in the workforce in Australia. Really, linking them into support networks and the healthcare system will help,” she said.
Ms Bayram and her colleagues say that the high degree of prescribing by overseas doctors may have economic implications for Australia. She also said that Australia needed better ways to gather data on overseas trained doctors. “We're relying on them to fill workforce gaps, so it's important that we know more about how they practise.”