The majority of GPs operate in solo practices, although the central government and the regions have offered economic incentives to encourage group practice and greater integration between GPs and social care, home care, health education, and environmental health services (see below). In 2010, there were approximately 53,500 general practitioners and pediatricians (33.3%) and 107,000 hospital clinicians (66.7%). Patients are required to register with a gatekeeping GP, who has incentives to prescribe and refer only as appropriate. People may choose any physician whose list has not reached the maximum number of patients allowed (1,500 for GPs and 800 for pediatricians) and may switch at any time.
Outpatient specialist care: Outpatient specialist care is generally provided by LHUs or by public and private accredited hospitals under contractual agreement with an LHU. Once referred, patients are given free choice of any public or private accredited hospital. Ambulatory specialists are generally paid on a per-hour basis, while hospital-based physicians are salaried employees.