I live in France and the GPs are not government employed like the UK - they work for themselves and are therefore 'freelance' if you like. (Although of course they are licensed to practice medicine...!) This means that if you go to a crap GP and don't like him/her, you can 'take your custom' elsewhere. Although there aren't many poor Drs, the good ones have motivation to keep up the good work and therefore earn a bigger payday at the end of the month.