A Reality Check on Cheap Loans - Why General Practice Needs more than Funding to Survive
Following the announcement of two-year low-interest loans for GPs and NPs to buy into or start their own practices, it has been framed by some as a major step forward for primary care in NZ/Aotearoa. Access to finance is important, but the idea that cheaper money alone will fix the challenges facing general practice is an oversimplification that risks setting clinicians up for disappointment.
In a conversation with Ryan Bridges this morning, a critical point emerged: it is naïve to assume that funding, without structure and strategy behind it, automatically leads to a sustainable business. Owning or running a practice is not just a clinical role with a mortgage attached. It is operating a complex small-to-medium enterprise in an environment of rising costs, increasing patient demand, workforce shortages and limited flexibility in traditional funding models.
Sustainability in general practice depends on far more than access to capital. A successful practice is built on a robust, well-structured business plan that goes beyond “opening the doors and seeing patients.” It requires a clear understanding of purpose, positioning and long-term direction, with realistic financial modelling and an honest assessment of risk. Without this foundation, even well-intentioned clinicians can find themselves working harder for diminishing returns.
Equally important is having the right people in the business, not just on the clinical side, but across operations, governance, finance, marketing, technology and patient experience. The most resilient practices are those led by teams with diverse skill sets, where each function is guided by someone who is an expert in their field. Expecting one or two clinicians to carry clinical load, management, compliance, staffing, finances and marketing is neither fair nor sustainable. Practices that invest in professional support around the doctor or nurse practitioner are better positioned to grow, adapt and withstand pressure.
Relying solely on capitation is increasingly difficult. Current funding structures were not designed for the realities of modern healthcare delivery, inflationary pressure, or growing patient complexity. Practices that survive and thrive are those that develop innovative, patient-driven revenue streams that complement traditional funding. This might include targeted preventive services, expanded nurse-led clinics, corporate health partnerships, digital health offerings, or structured allied health integrations. When revenue streams are diversified, the business is more resilient and patient care models can become more flexible and responsive.
Marketing and branding are often overlooked in healthcare, yet they are essential. Patients today choose services based on trust, accessibility, communication and experience, not just location. Practices that clearly articulate who they are, what they stand for and how they serve their community attract patients who align with their model of care. Strategic marketing is not about selling medicine; it is about communicating value, educating patients and building loyalty. Without visibility and engagement, even the best clinical service can struggle to grow.
Low-interest loans are helpful, but they are not a silver bullet. Without modern, “fit for purpose” business models and broader structural support, clinicians may simply be taking on debt without the tools to build something enduring. True reform in primary care requires investment not just in people, but in systems, leadership capability and commercial intelligence.
If the goal is to strengthen general practice long-term, funding initiatives must sit alongside education in business ownership, access to expert advisory support and policy settings that enable innovation rather than restrict it. It will be telling to see whether this move is the beginning of a more comprehensive approach to primary care reform, or whether it becomes another well-meaning solution that underestimates the complexity of running a sustainable healthcare business.
Primary care does not fail because clinicians lack commitment. It struggles when we expect them to be doctors, nurses, CEOs, CFOs and marketing managers all at once. If we are serious about the future of healthcare in New Zealand, we must build systems that allow clinicians to focus on care, supported by business structures that are strong enough to carry the weight of modern general practice.