Cheques and challenges: business performance in New Zealand general practiceRichard Greatbanks 1 , Fiona Doolan-Noble 2 , Alex McKenna 1
1 Department of Management, Otago Business School, University of Otago, Dunedin 9054, New Zealand
2 Rural Aotearoa Research Network, Department of General Practice and Rural Health, University of Otago, New Zealand
Correspondence to: Fiona Doolan-Noble, Rural Aotearoa Research Network, Department of General Practice and Rural Health, University of Otago, New Zealand. Email: firstname.lastname@example.org
Journal of Primary Health Care 9(3) 185-190 https://doi.org/10.1071/HC17047
Published: 25 September 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
INTRODUCTION: New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors.
AIM: To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice.
METHODS: For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data.
RESULTS: All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand.
DISCUSSION: As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of ‘super practices’ based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.
KEYWORDS: New Zealand; general practice; business performance; hybridization tension
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