C.A.L.L.S: Australia's alternative to bulk-billing medicine

Bulk billing is collapsing, consultations are getting shorter under rising patient loads, and GPs are leaving the profession faster than they are being replaced. This guide sets out what the evidence shows about the state of Australian general practice, and how daytime home visiting through C.A.L.L.S gives doctors a structurally different way to practise - fewer patients, higher pay per consult, and a working life that does not cost their health.

A system under measurable strain

Australia's primary care system runs on Medicare rebates that have not kept pace with the cost of delivering care. A rebate freeze between 2013 and 2019 held real payments flat while practice costs - rent, wages, insurance, compliance - kept rising. The result has played out in the bulk-billing rate. Cleanbill's national GP survey found the adult bulk-billing rate had fallen to around 20.7 percent nationally in early 2025, down from 35.1 percent just two years earlier, with average out-of-pocket costs for a standard consult continuing to climb.

The flow-on effect for patients is stark: the number of Australians avoiding a GP visit due to cost grew from roughly 600,000 in 2022 to more than 1.5 million by 2024. In November 2025 the federal government introduced a $7.9 billion incentive package to encourage bulk billing on every visit, but the scheme is voluntary, and many doctors have told the media they are wary of signing up after a decade of frozen rebates left them reluctant to rely on government funding decisions again.

What this does to consultation time

The RACGP's Health of the Nation 2025 report found the average time GPs spend with a patient rose to 19.7 minutes, up from 18.7 minutes in 2022 - an improvement, but one driven by rising patient complexity rather than a change in the underlying economics. Many bulk-billing clinics still schedule new patients every 10 to 15 minutes on booking systems such as HotDoc, and that slot has to cover more than the conversation: notes, scripts, referrals and pathology requests all have to be completed before the next patient is called in. Once that administrative work is accounted for, the real face-to-face time in a 15-minute slot is commonly closer to 5 to 7 minutes - not the full quarter hour the booking diary implies.

That gap between the booked slot and the time actually available for the patient is where diagnostic quality gets squeezed. A GP cannot properly assess a complex or multi-system presentation in 5 to 7 minutes, and the pressure to move on to the next booking is structural, not a matter of individual effort.

What this does to GPs

The workforce data reflects the strain. A global burnout survey reported by the RACGP found around 32 percent of Australian GPs report feeling burned out, and separate RACGP reporting has found close to a third of GPs intend to retire within five years, at a time when only a small share of medical graduates are choosing general practice as a career. A profession that is losing experienced GPs at one end and struggling to recruit at the other is not a stable system, regardless of how much goodwill individual doctors bring to the job.

A different model: daytime home visiting

C.A.L.L.S connects patients who want a doctor to come to them during the day with GPs who want to practise without the clinic's volume incentive. There is no rebate cap, no room rental to cover before earning, and no commission taken from the consultation fee. Visits are booked in 30-minute time slots, and the GP sets the price of the visit - commonly 150 to 350 dollars depending on complexity - and keeps all of it. The only cost is a flat monthly membership, the same whether the GP does 2 visits a week or 20.

Because the per-patient overhead is gone, so is the incentive to rush. A full 30-minute slot for every patient, paid in full, can match or exceed the daily billings of a clinic roster built around 25 to 30 six-minute slots - while spending real time with every patient and going home at a reasonable hour.

What the day actually looks like

Who this suits

GPs join C.A.L.L.S at every stage of their career. Some run it alongside existing clinic sessions to rebuild income without adding patient volume. Some use it to step down from full-time clinic rosters without leaving medicine altogether. Others build a full-time independent practice on it, setting their own service area, availability windows, and rate. There is no quota and no fixed roster - the GP decides the shape of the working week.