Exploring entrepreneurship among general practitioners: a scoping review of education and practice

The increasing complexity of healthcare systems demands a general practice workforce equipped with entrepreneurial competencies to lead innovation, adapt to system pressures, and enhance service sustainability. Traditional medical education for general practitioners (GPs) emphasizes clinical expertise but often overlooks essential skills in business acumen, leadership, and innovation. The aim of this scoping review was to examine how entrepreneurship is conceptualized, practiced, and supported among GPs in primary care, with a particular focus on identifying the barriers, enablers, and gaps across education, practice, and policy.

A scoping review following the Arksey and O'Malley framework and JBI's guidelines, to ensure methodological rigor. Literature searches were performed across SCOPUS, PubMed, and EMBASE (via Ovid), supplemented by citation searches. The strategy focused on entrepreneurship, primary healthcare, and General Practitioner. After screening and removing duplicates, relevant publications were selected through team discussion, resolving discrepancies by consensus. All included papers were coded for key themes and patterns, followed by thematic analysis to uncover key insights and trends in the field.

Eighteen studies were included, with most (13) examining entrepreneurship in GP practice, three focusing on education, and two addressing both. Seven themes were identified: challenges in practice, areas and types of investment, medical school characteristics, contextual factors, entrepreneurial skills, behaviours and orientation, policy-level factors, and motivations. Barriers were most pronounced at the micro (individual) and meso (practice/organisational) levels, including limited business training, role conflict, operational difficulties, and lack of structural support. Macro-level constraints, such as restrictive funding and regulation, further curtailed innovation. Despite these barriers, GPs engaged in diverse entrepreneurial activity, from corporate and partnership models to social ventures, often in response to workforce pressures and growing demand for chronic care. Evidence was heavily concentrated in Western contexts, highlighting the need for more globally diverse perspectives.

The review highlights significant gaps in educational preparation and systemic support, pointing to the need for changes in curricula, policy incentives, and practice structures. Guidance from medical councils, accreditation bodies, and GP associations will be key to embedding entrepreneurship into GP training and practice.