Authors: Anthony Scott1, Tamara Taylor2, Grant Russell3, Matt Sutton1,4

Affiliations:
1 Centre for Health Economics, Monash Business School, Monash University, Building H, Level 5, Caulfield East, Australia
2 Orima Research, Australia
3 Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Australia
4 Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, United Kingdom

Summary:

Primary care practices have traditionally been small, privately-owned entities managed by general practitioners (GPs). Over the last three decades, these practices have become increasingly owned by large corporate entities that can have non-GP shareholders and operate across multiple locations. How did these changes affect costs, access to care, and healthcare services quality?
We found that corporate medical groups were more efficient organisations than other practices. GPs spend less time on administration, have higher nurses-to-GP ratios, and overall suggest a model that might be leveraging economies of scale.
Patient access is somewhat better in corporate practices, as evidenced by lower fees and a higher percentage of bulk-billed patients, though this comes with slightly longer waiting times for preferred GPs. The increased efficiency does not compromise service quality, with no significant differences found in measures like teaching, patient complaints, consultation length, and the number of patients seen per hour.
Approximately 45% of GPs in Australia work in practices owned by private companies, of whom 20% are employed in corporate medical groups with ten or more practice locations. These practitioners tend to be older, qualified overseas, and conscientious. Compared with their non-corporate peers, they report similar levels of job satisfaction and similar workload in terms of hours worked. However, work-life balance and turnover are lower among GPs in corporate settings.
However, while corporate medical groups may offer some benefits regarding efficiency and patient access, concerns remain about GP wellbeing and the potential implications on the quality of care. The corporatisation of primary care practices in Australia has brought benefits in organisational efficiency and patient access. However, its long-term impacts on the wellbeing of GPs and the continuity and quality of care still need monitoring.