Buying a GP clinic: where are all the women?

For some female GPs, the decision on whether or not to buy into a general practice is a particularly difficult one

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The thought of becoming a small business owner had not crossed Kate’s mind earlier in her career, but here she was at a three-day seminar on finance, tax and business structures.

For Kate (not her real name), a decision on whether or not to buy a five-doctor general practice from her retiring boss is a difficult one.

A general practitioner and mother of a two-year old, Kate hoped the Sydney Private Practice Women in Medicine symposium, held this month, would help her make this big financial and life decision.

“You have a choice to make,” a colleague once told her, “either you can own your practice or you can have a second baby”. That advice was unsettling, but probably true, Kate conceded.

A key factor for Kate is the fear that a big player will swoop in, pay each doctor upwards of $50,000 each as a sign-up fee, and turn the community practice into an outlet for, what another symposium participant described as “trash medicine”.

The proportion of female GP owners compared with men was thought to be low, although the actual ratio was unknown, Professor Anthony Scott, a health economist at The University of Melbourne, told The Medical Republic. 

Fewer women than men were members of the Australian General Practice Alliance, which advocates for GP owners. If substantial numbers of female GP owners existed, they were yet to come out of the woodwork, Dr Charlotte Hespe, a GP practice owner and director at the alliance, said.

Overall, practice ownership by GPs was on the decline, with only one-quarter of GPs acting as partners or principles, according to the national longitudinal survey of doctors known as the MABEL survey.

“This could reflect growing corporate ownership, but could also reflect younger and female GPs having stronger preferences for more-flexible work arrangements as employees rather than as small business owners,” Professor Scott said.

Some female GPs viewed the responsibility of owning a practice as directly conflicting with their personal life.

Others lacked the confidence or sense of financial security to make bold investment decisions, Louise McCann, the NSW manager at Medfin, a bank that specialises in financing medical practices, said.

Women consistently score higher for financial anxiety than men, although women are better at keeping track of finances and not spending impulsively, according to the ANZ bank’s Survey of Adult Financial Literacy in Australia (2015).

And as of this year, women outnumbered men in general practice, accounting for 50.2% of all GPs – a reality not always recognised in the financial services industry.

One doctor at the Sydney symposium said financial advisers had not taken her seriously as a professional. “I don’t want to be told to give up my practice insurance because I’ve had a baby, or be asked what my husband does,” she said.

Another doctor said sexism in the industry had turned her off seeking financial advice altogether.

Female GPs might hesitate to purchase a practice if they could not provide a house as collateral, whereas male GPs might have other assets, or have a higher tolerance for risk, Ms McCann said.

But doctors didn’t need to own a $2 million house to buy a clinic, she said. Some banks would be willing to lend doctors 100% of the equity of the practice through goodwill funding alone.

“You don’t need to have a whole heap of assets to buy a practice,” she said.

“If the practice has a strong client base and a good history, that’s enough. Doctors are viewed as low-risk investments. We don’t have too many doctors that go bad.”

Ms McCann recommended GPs shop around for financing.

“Doctors are different,” she said. “Make sure you are getting the special treatment you deserve. Have the confidence to do it, because we know, as GPs, you can generally make it work.”