Experience and practical thinking from across our primary care network. Our contributors explore the decisions facing practices, clinicians and health organisations, from supporting teams and improving services to governance, succession and taking new ideas to market.
We share what we have learnt to help people make informed decisions and contribute to a stronger primary care sector.
39 articles
Patients are using more care than a year ago, they are bulk billed more often, and they still separate the care they receive from the system that delivers it. What the 2026 NAB Health Insights Report means for a practice owner.
Read articleWhat the research says about how people choose work and why they stay in it, where it stops, and how Medius Match uses it.
Read articleThe evidence that seeing the same doctor over time lowers mortality, hospital use and cost is now among the largest in medicine. Why episodic funding erodes continuity, what the system gets for it, and three ways to fund the relationship instead.
Read articleLean thinking, adapted from the Toyota Production System, gives a GP practice team a practical way to see waste. The eight types of muda, the role of mura and muri, and the lean tools (5S and kaizen) that make improvements stick.
Read articleEffective delegation sits between micromanagement and abdication. Hersey and Blanchard's situational leadership model, applied to GP practices, and why you can delegate responsibility but never accountability.
Read articleAll GP registrars must be engaged as employees, not contractors. Mark Donato explains the legal, regulatory and commercial realities for Australian general practice, and the risks of non-compliance.
Read articleMost GP practice change failures occur because teams are asked to change behaviour before they understand why, want to be part of it, or have any friction removed from the new way of working. Bottom-up approaches with shared vision, concrete scripted actions and incremental testing produce better results than top-down plan delivery.
Read articleSuccessful change in GP practice requires meeting discipline, well-designed incentives and structured improvement cycles. Meetings without written actions and deadlines produce conversations rather than change. Incentives that reward proxy behaviour instead of the behaviour you want will backfire.
Read articleManaging a practice is not the same as running one. A practice manager focuses on operational management: what is in front of them. A business manager oversees financial strategy, drives income growth, manages risk across multiple domains, and makes decisions that determine where the practice is heading. Nine competency areas define the full scope of the role.
Read articleAustralian GPs lose roughly a fifth of their working week to non-billable administrative tasks. This post sets out a practical time management system grounded in Stephen Covey's urgent/important matrix, adapted for general practice and supported by peer-reviewed evidence.
Read articleWhen you join a board, you take on legal duties that exist independently of whatever value you bring as a clinician. The Corporations Act 2001 sets out what directors must do and what happens when they fail.
Read articleBoards rarely recruit by job title. They recruit against a skills matrix. For a GP who wants a director role, the medical degree is an entry point, but it is not the argument.
Read articleDoctors bring critical value to boards that is not easily replicated by any other disciplines, and the evidence for that is now substantial. Multiple studies have found that organisations with doctors on their boards perform better on core measures of quality and safety.
Read articleAround 80% of board positions in Australia are filled through networks and word of mouth rather than through advertised vacancies. That figure reshapes how any GP serious about governance should be spending their time.
Read articleHow a GP makes decisions is shaped by decades of clinical training and reinforced every working day. That pattern of autonomous, fast decision-making is what makes general practice work. It is also what makes the transition into a board role disorienting.
Read articleIn health and aged care, the way boards are judged has shifted. Regulators and funders now look at how directors oversee clinical care, not only how they manage money and reputation.
Read articleA facilities and services agreement is the contract between a practice entity and each independent GP who consults from the practice. If these agreements are missing, expired, unsigned or poorly drafted, the buyer has no enforceable basis for revenue continuity after settlement.
Read articleAustralian health SMEs often have valuable offerings but struggle to connect with buyers, not because of product issues but because of access. The founders, executives and procurement decision-makers running health organisations are not hard to find; they are hard to reach without prior credibility, sector knowledge and trusted relationships.
Read articleThe most telling sign of a strong fractional business development operator for a health organisation is how they approach the pre-planning phase: do they conduct a structured audit of your systems, pipeline, competitive position, relationships, and staff before choosing any direction? Sector experience, AI-enabled systems, and documentation practices are also crucial.
Read articleSmall and medium-sized health organisations are often drowning in data but lack actionable insights. The real issue is not access; it is that organisations are not linking analysis to commercial questions. A data audit usually surfaces utilisation patterns, customer fit, behaviour-based archetypes, system failures and the complaints infrastructure most SMEs do not have.
Read articleFractional business development is well established in the US and UK but slower to take hold in Australia. General BD experience does not transfer cleanly to health. The sector has its own commissioning logic, relationships, regulatory constraints and timelines. Research shows prior industry experience is the strongest predictor of success.
Read articleThe Medicare rebate has not kept pace with practice costs for two decades. Where the financial pressure on general practice comes from, the billing gaps most practices can close, and the revenue diversification that holds up under scrutiny.
Read articlePathology rent, allied health sub-leases, imaging tenancies and pharmacy arrangements generate income that does not depend on GP clinical labour. That makes them attractive to buyers. But informal or poorly documented arrangements create the opposite effect. The gap between what the seller thinks the income is worth and what the buyer will pay for it is almost always a documentation problem.
Read articleAdd-backs are expenses reversed out of reported profit because they reflect the current owner's personal choices, one-off events or related-party arrangements rather than ongoing business operations. Done properly, normalisation shows the practice's earning capacity at arm's length. Done poorly, it looks like the seller is inflating the price.
Read articleSince 1 November 2025, the federal government's Bulk Billing Practice Incentive Program has changed the financial calculus for every practice owner in Australia. The answer depends on your patient mix, your location, your consultation patterns, and what you plan to do with the practice over the next five years.
Read articleThe ATO published Practical Compliance Guideline PCG 2025/5 on 1 December 2025. It sets out the Commissioner's approach to Personal Services Income and how the general anti-avoidance rule under Part IVA applies to PSI structures. If you run your business through a company or family trust, this applies to you.
Read articleBuyers assess GP practices against a set of financial benchmarks that indicate profitability, cost control, revenue stability and documentation quality. These metrics determine whether a practice attracts serious interest and the range in which offers land.
Read articleOwner-GP billings are personal labour income. They flow through the practice accounts, but they depend on the owner continuing to see patients under their own provider number. If the owner stops consulting, those billings stop.
Read articleMost GP owners have a reasonable grasp of what their practice earns. Fewer have a clear picture of what it earns once their own involvement is stripped out. That gap is what normalisation is designed to close.
Read articlePart 4 of the internal GP practice buyouts series. The shareholders agreement, sale agreement, restraint of trade, post-settlement consulting, facilities and services agreements, and employment obligations: what the document suite must cover.
Read articleMost internal GP practice buyouts use vendor finance because bank financing of goodwill is unavailable. The structure is workable, but the transactions that become disputes are usual in structure and deficient in documentation.
Read articleThe EBITDA multiple provides a defensible valuation, but internal buyers often can't fund it from practice income. Three buyer objections explain most failed negotiations, and only one of them is resolved by an independent valuation.
Read articleInternal GP practice buyouts collapse more often than external sales. Five structural patterns explain why: valuation disconnect, service fee transparency, trust as a commercial substitute, buyer familiarity gaps, and vendor finance without an exit mechanism.
Read articleBuyers use your stated reason for selling to assess risk before they open your financials. It affects the scope of due diligence they apply and the structure of their offer. A rationale that signals urgency or instability produces lower offers and more intensive scrutiny than one that signals a planned, stable transition.
Read articleMost GP practice sales that disappoint on price share a structural feature that due diligence reliably surfaces: the business does not function independently of the owner. The owner is the primary billing clinician, the decision-maker for operational matters large and small, and the person who holds the key relationships with long-term patients and referring specialists.
Read articleMost GP practice owners will likely understand that a rushed sale produces a worse outcome than a planned one. The valuation discount for a reactive sale is real; it is not small, and it arises from factors such as limited preparation time, fewer interested buyers, and reduced bargaining power.
Read articleThe multiple gets most of the attention when GP practice owners think about selling. But there is a second variable that receives far less scrutiny before the deal closes: who the buyer is, and what working life looks like once the original deal conditions expire. Without competitive tension, there is no price discovery and no leverage over post-settlement terms.
Read articleMost GP practice sales do not fail because the business is bad. They fail because the owner cannot produce the right information at the right time. This checklist covers everything you need to have at hand before starting the sale readiness assessment.
Read articleGP workforce stability is a direct indicator of business sustainability. Buyers purchase predictable, transferable earnings. If the practice relies on locums, has unfilled sessions, or faces imminent GP departures, those earnings are uncertain.
Read articleBuyers and financiers typically look for at least three to five years of remaining lease term at settlement, with options beyond that. Leases of three years or less increase the risk that the business will need to relocate or renegotiate from a weak position soon after purchase.
Read articlePractice owners preparing for sale face a key decision that determines transaction structure, timeline and outcomes. Do you prioritise legacy and community continuity, staff retention and culture preservation, or pure financial optimisation and capital realisation?
Read articleTell us what you are trying to work out and we will tell you whether we can help.
