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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

General practitioners’ perceptions of different practice models: a qualitative study

Catherine Joyce A D , Hayley McDonald A C and Laureen Lawlor-Smith B
+ Author Affiliations
- Author Affiliations

A School of Public Health and Preventive Medicine, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, Vic. 3004, Australia.

B Southern Adelaide–Fleurieu–Kangaroo Island Medicare Local, Mitsubishi Administration Building, Level 1, 1284 South Road, Clovelly Park, SA 5039, Australia.

C Present address: Monash Injury Research Centre, Monash University, Building 70, 21 Alliance Lane, Clayton Campus, Vic. 3800, Australia.

D Corresponding author. Email: catherine.joyce@monash.edu

Australian Journal of Primary Health 22(5) 388-393 https://doi.org/10.1071/PY15025
Submitted: 13 February 2015  Accepted: 14 June 2015   Published: 9 September 2015

Abstract

Ownership of general practices is changing, but perceptions of GPs about ownership and the factors influencing their decisions about this are not well understood. The aim of this study was to explore GPs’ perceptions and attitudes towards different practice models. GPs (n = 138) in the Southern Adelaide-Fleurieu-Kangaroo Island Medicare Local region participated in semi-structured interviews, which were analysed thematically. Thirty-nine per cent of participants were practice owners, and 64% were working in a practice with six or more GPs. Factors driving practice ownership were flexibility, autonomy and financial reward. Factors discouraging ownership were increased responsibility, time commitment and the potential for financial burden. Some interest in future practice ownership was evident, but concerns were also raised about the knowledge and skills required. Strategies are needed both to support GPs who do wish to be practice owners and to facilitate a range of practice models to ensure continued delivery of accessible, quality primary medical care to patients.

Additional keywords: general practice, practice ownership.


References

Anderson R, Haywood P, Usherwood T, Haas M, Hall J (2005) Alternative to for-profit corporatisation: the view from general practice. Australian Journal of Primary Health 11, 78–86.
Alternative to for-profit corporatisation: the view from general practice.Crossref | GoogleScholarGoogle Scholar |

Australian Government Department of Health (2007) Australian Standard Geographical Classification – Remoteness Area (ASGC-RA). Available at http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/ra-intro [Verified August 2014]

Australian Government Department of Health (2014a) About the GP super clinics program. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-gpsuperclinic-about [Verified August 2014]

Australian Government Department of Health (2014b) General practice statistics: GP workforce statistics - 1984–85 to 2012–13. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/General+Practice+Statistics-1 [Verified July 2014]

Australian Government Department of Health and Ageing (2012) State of corporatisation: a report on the corporatisation of general practices in Australia. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/foi-disc-log-2012-13/$File/222-1213%20Doc%206%20State%20of%20Corporatisation%20Report%20-%20February%202012.pdf [Verified 10 August 2015]

Australian Government Medicare Local (2014) SA – Southern Adelaide – Fleurieu – Kangaroo Island – Medicare Local general practice workforce statistics. Available at http://www.medicarelocals.gov.au/internet/medicarelocals/publishing.nsf/Content/Southern+Adelaide+-+Fleurieu+-+Kangaroo+Island-statsgp#.U8M_pp1–Un [Verified 10 August 2015]

Australian Medical Association (2010) Corporatisation of general practice: decision support kit for doctors. Australian Medical Association, Kingston, ACT.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.
Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |

Britt H, Miller G, Henderson J, Bayram C, Valenti L, Harrison C, Charles J, Pan Y, Zhang C, Pollack AJ, O’Hallaoran J (2013). ‘General practice activity in Australia 2012–13. General practice series no. 33.’ (Sydney University Press: Sydney, NSW)

Caldwell TM, Jorm AF, Knox S, Braddock D, Dear KB, Britt H (2004) General practice encounters for psychological problems in rural, remote and metropolitan areas in Australia. Australian and New Zealand Journal of Psychiatry 38, 774–780.
General practice encounters for psychological problems in rural, remote and metropolitan areas in Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2cvmtVyqsw%3D%3D&md5=b43f9c90de8bcc43f35195aeb88adba1CAS | 15369535PubMed |

Catchlove BR (2001) The why and the wherefore. The Medical Journal of Australia 175, 68–70.

Charles J, Britt H, Valenti L (2004) The evolution of the general practice workforce in Australia, 1991–2003. The Medical Journal of Australia 181, 85–90.

Damiani G, Silvestrini G, Federico B, Cosentino M, Marvulli M, Tirabassi F, Ricciardi W (2013) A systematic review on the effectiveness of group versus single-handed practice. Health Policy (Amsterdam, Netherlands) 113, 180–187.
A systematic review on the effectiveness of group versus single-handed practice.Crossref | GoogleScholarGoogle Scholar |

Fitzgerald PD (2001) The ethics of doctors and big business. The Medical Journal of Australia 175, 73–75.

Hansen V, Pit S, Honeyman P, Barclay L (2013) Prolonging a sustainable working life among older rural GPs: solutions from the horse’s mouth. Rural and Remote Health 13, 2369

Humphreys JS, Jones JA, Jones MP, Mildenhall D, Mara PR, Chater B, Rosenthal DR, Maxfield NM, Adena MA (2003) The influence of geographical location on the complexity of rural general practice activities. The Medical Journal of Australia 179, 416–420.

Kurukchi G (2009, 22 May) A corporate practice is born. Australian Doctor. Available at http://www.medicalpracticemanagement.com.au/files/docs/mpm/mod-1b/fr-mod1b.5.1ausdracorporatepracticeborn.pdf [Verified 31 August 2015]

Lewis J, Marjoribanks T, Pirotta M (2003) Changing professions: General Practitioners’ perceptions of autonomy on the frontline. Journal of Sociology 39, 44–61.
Changing professions: General Practitioners’ perceptions of autonomy on the frontline.Crossref | GoogleScholarGoogle Scholar |

Liedvogel M, Haesler E, Anderson K (2013) Who will be running your practice in 10 years? Supporting GP registrars’ awareness and knowledge of practice ownership. Australian Family Physician 42, 333–336.

Lipscombe MV (2003) Practice management. The Medical Journal of Australia 179, 51

McGrail MR, Humphreys JS, Joyce CM, Scott A, Kalb G (2012) How do rural GPs’ workloads and work activities differ with community size compared with metropolitan practice? Australian Journal of Primary Health 18, 228–233.
How do rural GPs’ workloads and work activities differ with community size compared with metropolitan practice?Crossref | GoogleScholarGoogle Scholar | 23069366PubMed |

McNamara S (2007, 17 August) Corporate lure stronger than ever. Australian Doctor. Available at http://www.australiandoctor.com.au/news/latest-news/corporate-lure-stronger-than-ever [Verified 31 August 2015]

Mott K (2001) The consumer perspective. The Medical Journal of Australia 175, 75–76.

Royal Australian College of General Practitioners (RACGP) (2007) General practice management toolkit. Available at http://www.racgp.org.au/your-practice/business/managementtoolkit/ [Verified September 2014]

Ryan G, Bernard H (2003) Techniques to identify themes. Field Methods 15, 85–109.
Techniques to identify themes.Crossref | GoogleScholarGoogle Scholar |

Shrestha D, Joyce CM (2011) Aspects of work-life balance of Australian general practitioners: determinants and possible consequences. Australian Journal of Primary Health 17, 40–47.
Aspects of work-life balance of Australian general practitioners: determinants and possible consequences.Crossref | GoogleScholarGoogle Scholar | 21616023PubMed |

Smith P (2006, 14 July) Most GPs say corporates damaging the profession. Australian Doctor.

Sofaer S (1999) Qualitative methods: what are they and why use them? Health Services Research 34, 1101–1118.

Sprogis A (2001) The divisional alternative. The Medical Journal of Australia 175, 70–72.

Sturgiss E, Anderson K, Liedvogel M, Haesler E (2013) To own or not to own: how can we best educate general practice registers about practice ownership? Australian Family Physician 42, 503–506.