Into the unknown: the anticipation and experience of membership of independent practitioner associations.
OBJECTIVE
To understand why general practitioners (GPs) joined independent practitioner associations (IPAs), their concerns on joining, and the extent to which both positive and negative expectations have been realised.


METHODS
A self-complete postal questionnaire to a sample of IPA rank-and-file members invited their views on their decision to join, their satisfaction with leadership, and the experience of being in an IPA.


RESULTS
The most popular reasons for joining were related to the uncertainties of the health sector environment, including the prospect of contracting and the place of general practice within the health sector. Aspirations on joining were largely realised, although at a general rather than specific level. Concerns over joining related mostly to day-to-day operation and practitioner autonomy, but were less strongly held and less likely than aspirations to be realised. Satisfaction with IPA leadership was quite high and associated with practitioner involvement in IPA activities.


CONCLUSIONS
Results are consistent with the international literature, with importance attached by practitioners to both 'personal' and 'system' level aspirations. Research also suggests that where management remains 'connected' with rank-and-file clinicians then perceived threats to autonomy are likely to be minimised. In moving towards primary health organisations, care needs to be taken not to undermine this 'connectedness' and therefore pose risks to the effective management of primary care.
Barnett
Pauline
P
Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand. pauline.barnett@chmeds.ac.nz
D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007193:Independent Practice Associations / Q000458:organization & administration / Q000706:statistics & numerical data; D008297:Male; D009520:New Zealand; D010821:Physicians, Family / Q000458:organization & administration / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires