Table 4

Environmental enablers and essential service requirements for the 'Easy entry-gracious exit' discrete model

Environmental enablers

Supportive policy

Initial Commonwealth grant funds enabled provision of practice equipment & furnished doctor housing. Following this, the Rural Medical Infrastructure Fund supported the model.

Commonwealth/State relations

Commonwealth and State agencies negotiated contracts of service to cash out some services, enabling a reliable income stream which enabled more specific income estimates for prospective doctors

Community readiness

There was a strong community commitment to finding solutions to the GP recruitment problem and local champions to drive the change to community ownership of infrastructure.

Essential service requirements


Recruits from a larger pool due to limited infrastructure investment requirement. Expanded GP role provides additional positions so can provide self-cover for after hours and on-call work.


Cashing out of hospital Visiting Medical Officer services, population health activity, Extended Primary Care (EPC) items, other Medicare and Retention Grants fund bulk-billing service.

Governance, management & leadership

Community, agencies (eg Division of General Practice, Area Health Service, Rural Workforce Agency) represented on Board. Professional business management instituted.


Provides a platform for integration. Strong community & other linkages as above. Enables EPC activity involving allied health team.


Community ownership through Rural Medical Infrastructure Fund, local government, Practice Incentives Program, Area Health Services. Potential collocation with hospital or community services.

Wakerman et al. BMC Health Services Research 2008 8:276   doi:10.1186/1472-6963-8-276

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