Enter the Supermarket: Entrepreneurial Medical Practice in New Zealand

Abstract

New Zealand, like many other capitalist countries, has recently witnessed an increased corporate involvement in medicine. One manifestation of this change has been the entry of medical ‘supermarkets’—multipurpose clinics which juxtapose general practitioners (GPs) and specialists, are company owned, and employ advertising. The authors document the development and implications of these clinics which, although small in number, have induced change in the behaviour of the GP community at large. They conclude that recent developments involve a ‘coming out of the closet’ of a fundamental contradiction in the way general practice is conducted in New Zealand. This is between the role of the caring providers founded on the Hippocratic oath, and that of income-generating business people within an increasingly market-driven society. This contradiction leads to speculation on a broader question: The degree to which competition among primary care provides is possible within fee-for-service and other types of health-care systems.