The influence of funding models on collaboration in Australian general practice

Despite more nurses working in Australian general practice, there has been limited investigation exploring ways that general practitioners and registered nurses work together to deliver clinical care. However, it has been postulated that the small business structure, common in Australian general practices, might influence collaboration between these two groups of health professionals. This paper presents one theme from a larger qualitative study. Eight general practitioners and fourteen registered nurses working in general practice participated in semistructured face-to-face interviews between February and May 2015. Naturalistic inquiry was adopted to elicit and explore the narrative accounts of participants about working together in general practice. An inductive process of thematic analysis was used to identify, analyse and report patterns and themes. Ancillary costs associated with the employment of registered nurses in general practice and the time registered nurses took to undertake procedural services were a concern for general practitioners. Registered nurses did not always work to their full scope of practice and many felt that their expertise was not appropriately remunerated. Findings suggested that fee for service-funding models can negatively influence collaboration between general practitioners and registered nurses working in general practice.