How are large, corporate GP clinics impacting patient care?

A shift in the general practice structure to larger practice could impact Australia’s future patient care, according to the authors of the Outlook article published in. Australian Medical Journal..Author of La Trobe University Department of Public Health, Dr. Caroline de Moel-Mandel and Professor Vijaya Sundararajan, point out that the organizational structure of general practice in Australia has changed significantly since the late 1990s.

“Currently, 2% of Australian GPs work in a single private practice, 20% of full-time GPs and 33% of part-time GPs are employed in large-scale practices, including 6 or more GPs. “The author writes.

Clinic ownership has also changed, with 25% of Australian GPs being clinic owners in 2020, compared to 35% in 2008. The author explained that factors such as administrative responsibility, financial burden, and lack of work-life balance discouraged ownership of the clinic.

“At the same time, a commercial ownership model has emerged in which shareholders have little or no involvement in patient care or care management, from ownership by other healthcare professionals to corporate groups of listed companies,” the author writes.

“In 2000, there were six corporate groups. By 2020, there were two remaining operating more than 400 medical centers. According to 2020 survey data, about 16% of GPs are corporate-owned practices. The number of services in the same location has also increased. In 2016, 81% of medical treatments received pathology services at the location, compared to 49% in 2010. For imaging , These numbers are 30% vs. 15%, respectively, and 50% vs. 29% for physical therapy. “

Dr. De Moel-Mandel and Professor Sundararajan explained that the size and model of ownership of general practitioners affects the following areas:

  • Access to care Especially for people living in areas or remote areas where per capita GP is already low, multiple smaller practices can be affected if they come together in a larger, more centralized practice.
  • Continuity of care: In large-scale practice, a person’s “normal GP” is often replaced by “normal practice”, resulting in the patient consulting a GP that he has never met.
  • Quality of care: The author pointed out a study suggesting that the quality of commercialized GP services may be inferior to those offered by traditional providers.
  • Medical bills: The observed increase in spending may be related to over-service implementation to reach income targets, or over-reference to services that are commercially relevant and co-located by the GP. there is.

The authors conclude that more studies are essential to fully understand the impact of GP size and ownership model changes on patient care.

“There is little Australian evidence that individual or corporate-owned general practice provides worse clinical care, but there is also little evidence that care is better. Therefore, Australian general practice is the size, ownership, and ownership of practice. More Australian studies to track and control what this means for patient care as well as patients when it comes to navigating future changes in increasingly co-located service organizations. And potential regulation is needed not only for experience, but also for health outcomes in general practice. “

Image credit: © / au / sepy

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