There is an ongoing negative commentary about ‘corporates’ in New Zealand general practice. The argument goes that independent ownership by clinicians is the only model that can be trusted to serve patients well and that larger organisations must be purely motivated by profit (in a sector where profit-making small businesses are the norm). This has prompted me to reflect on what these debates mean for the more than 150 GPs and as many other healthcare professionals who work at Tend every day.
Every day, Tend clinicians arrive at clinics nationwide to provide care to more than 140,000 enrolled patients. They bring the same commitment to patient care, professional standards and obligations as clinicians in any practice. Our team spans Fellows, registrars and international graduates, all doing demanding work. To suggest that practice ownership undermines the quality of their care is not just wrong, it’s disrespectful.
In practices integrated into Tend’s model, wait times have fallen from 28 days to 6. Urgent care presentations have dropped by 26%. Patient satisfaction has risen from below 70% to above 90%. These are not corporate metrics, they are outcomes that matter to patients and should matter to our profession.
Good clinical governance isn’t determined by who owns a practice. It rests on systems, leadership and culture. At Tend, a governance framework developed by practising clinicians, with multiple layers of clinical leadership, ensures that clinical considerations drive decision-making at every level.
Rehabilitating distressed practices, correcting safety issues, relieving extraordinary GP workloads, funding CME and study leave, building AI tools to reduce administrative burden, all takes significant time, effort and tens of millions of dollars. No system is perfect, but at Tend a culture of building, testing and learning is making tangible progress.
Telehealth is another area where myths persist. At Tend, two-thirds of consultations remain face-to-face; one-third are telehealth when clinically appropriate and patient-preferred, all carefully designed around RNZCGP and MCNZ telehealth guidelines. Telehealth is not a replacement for face-to-face care, but a way to lower barriers: a working parent managing a child’s eczema without losing wages, a rural patient avoiding a two-hour round trip to get treatment for gout, or a timely virtual follow-up that improves continuity of care.
We must be honest with ourselves about the state of primary care: a capitation formula lagging well behind cost of care delivery, critical workforce shortages, persistent inequities, outdated systems, unsustainable workloads and an aging population with rising chronic disease. Appeals to traditional ownership models will not solve these problems. Innovation and investment might.
Our profession faces enough external challenges without fuelling internal division. Whether in a two-GP practice, a community trust or a larger organisation, we all share the same risks, obligations and commitment to patient care.
Rather than debating ownership, let’s judge providers on what matters: quality, outcomes, access, equity and clinician wellbeing. Our 150-plus GPs are colleagues who deserve recognition, not dismissal. As primary care evolves, let’s keep the focus on delivering the best care to all New Zealanders.