Costing Healthcare : A Study of the Introduction of Cost and Budget Reports into a Gp Association

This paper describes a case study of the development of cost and budget reports in a group of general practitioners in New Zealand. There have been numerous attempts to introduce management accounting tools in hospitals, however, little attention has been paid to the role of management accounting in a primary care setting. While accounting is often represented as a threat to medical autonomy it was found that GP's did not perceive accounting as a threat, but rather as a process of peer review and education. One reason why the accounting controls were accepted was that they played an important boundary function in creating and maintaining the association. The accounting controls were also seen by GPs as being consistent with their accountability to their peers and, therefore, they were not resisted as a managerial intrusion