As a medical group grows, the thing that quietly determines whether it stays true to its purpose is governance — the structures that decide who makes which decisions, and to whom they answer. It’s an unglamorous subject that turns out to matter enormously.
Clinical and commercial decisions are not the same
Good governance in healthcare starts by separating two kinds of decision. Clinical decisions — how patients are cared for — belong with clinicians. Commercial decisions — how the organisation is funded and run — have to be sound, but they must not reach into the consulting room. Where that line blurs, patients are the ones who pay. Keeping it sharp is a governance choice, made deliberately and defended over time.
Owner-led, not absentee
I completed the Australian Institute of Company Directors course in 2018 because running a network of this size demands real discipline: financial rigour, risk management, accountability. But discipline doesn’t require handing control to people removed from the work. Family Doctor is doctor-owned and owner-led — the people accountable for the organisation are the people who understand what happens in a clinic.
When we took on private credit from KKR in 2025, governance was central to how we structured it: financing that funds the mission without giving an outside party a vote over clinical or strategic direction. Capital is useful; control is not for sale. That, to me, is what governance in healthcare is ultimately for — making sure the organisation can grow without losing the thing it exists to do.
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