Alternatives to for-profit corporatisation: The view from general practice

Abstract

The aim of this study was to assess the expressed preferences of general practitioners (GPs) for alternative organisational models to for-profit GP corporatisation. A review of the findings of six feasibility studies that examined alternative organisational models for general practice in Australia was undertaken. Five feasibility studies were conducted within nine Divisions of General Practice, and a feasibility study was conducted by a state-based organisation among all 15 of its member Divisions. Overall, the six projects demonstrated a strong resistance among most GPs to any alternative model that involved giving up autonomy over practice matters. Consequently, the most favoured alternative organisational model was the "service company" - the establishment of a third party to provide a range of practice support services. In general, there was implicit acceptance that the service company could recover the cost of support service provision by charging GPs on a fee-for-service basis, and also that the Division itself would be the most acceptable organisation to take on this role. However, in four Divisional areas GPs revealed very low motivation towards either working together or with the local Division as a service company. Although these feasibility studies were carried out using different methods, and in a small sample of mostly urban Divisions, they suggest that many GPs would support their Divisions - or some other Division-related third party - to become more active providers of a range of practice support services.