Aim: To provide a description of the invoices created for services delivered in a private general practice in a rural area of New Zealand with a view to assessing the value of the services to the community and the rewards to the private business.
Method: Analysis of computer-based invoices and description of the working arrangements of the practice.
Results: A 24-hour, 365-day service was delivered to a local community at a cost of 129 dollars per patient per year, exclusive of the cost of drugs, laboratory, and other investigations and hospital referrals. The rewards for the professionals were mixed, with adequate reimbursement for 8 am-5 pm, 5-day care but those for the out-of-hours and maternity parts of the business were poor, with hourly rates far below New Zealand's minimum wage.
Conclusion: The recent cosmetic changes to New Zealand Primary Health Care have failed to resolve the challenge of delivering personal medical care to rural communities. Investment in the small business of general practice has the potential to solve the rural health crisis.