Exploring considerations for becoming a GP practice owner: a qualitative study

Background: General practice owners are responsible for access to care 24 hours a day, but they can struggle to find associates or successors. Fewer practice owners means that the core value, continuity of care (COC), is at risk. However, little is known about the career considerations of young GPs and barriers and facilitators to become practice owners.

Aim: To explore the considerations of GPs for becoming a practice owner.

Design & setting: A qualitative study of GP trainees, freelance and salaried GPs, practice owners, and ex-practice owners in the north of The Netherlands.

Method: Ninety GPs were purposively recruited for focus groups and interviews, which were audio and video-recorded, transcribed verbatim, and analysed thematically.

Results: Becoming a practice owner results from a complex interplay between professional, personal, external, and process-related factors, often over an extended period. Participants indicated that COC, autonomy, and personal development had predominantly positive impacts on decisions about practice ownership. Factors that negatively affected considerations included work–life balance, ultimate responsibility, negative role models, unappealing practices, (un)preparedness, and issues with the process. Of note, non-practice owners felt that practice ownership could not be discussed.

Conclusion: Modifications to perceived behavioural control and subjective norms are needed, together with an open dialogue among GPs about practice ownership and alternative models. Our findings offer a foundation for further prospective quantitative research into efforts designed to address the shortage of practice owners in The Netherlands and other countries. This could uncover universal and country-specific themes.