What if we applied the same analytical rigour we give our finances to the wellbeing side of general practice?
We’re meticulous about tracking financial assets and liabilities. Yet the very people who generate all that value—ourselves, our colleagues, our teams—rarely get the same systematic assessment. And when burnout strikes or someone unexpectedly leaves, we feel the pain of that too.
Can we create a “human balance sheet” for general practice? Not to reduce people to numbers, but to bring the same intentionality to wellbeing that we bring to finances. Stick to the end, and I’ll share with you a tool to help assess your wellbeing.
The Human Assets
Just like any business, we have assets. But instead of property and equipment, our human assets look like this:
Energy & Vitality: This is like your cash on hand. It’s the most liquid resource you’ve got. Can you actually show up fully for your patients and colleagues? Or are you running on fumes?
Skills & Competencies: Your clinical knowledge, your communication abilities, and your leadership skills. These appreciate over time when you invest in them, just like property.
Relationships & Trust: The bonds between colleagues, rapport with patients, goodwill in the community. This is your goodwill asset. It’s built slowly, and it’s absolutely invaluable.
Purpose & Meaning: That sense that your work actually matters. This might be the most intangible asset, but honestly? I believe it drives everything else.
Time & Attention: Your capacity to focus, to be present, to think deeply. In primary care, this is increasingly scarce.
The Human Liabilities
We’re less comfortable talking about these, but they’re just as real:
Chronic Stress & Exhaustion: This is like a loan you’ve taken out against your future self. The accumulated toll of years of pressure, inadequate breaks, and emotional labour.
Unprocessed Trauma: Difficult patient outcomes, complaints, the sheer weight of responsibility. This compounds over time if you don’t address it.
Resentment & Cynicism: That bitterness that grows when the workload feels unsustainable or you feel undervalued. This erodes your asset base.
Obligation & Guilt: The feeling that you can never do enough, that taking time off means letting people down. This liability keeps you perpetually overextended.
Skills Erosion: When you’re so busy just surviving that you stop learning, stop growing. Your competence asset starts to depreciate.
Let Me Show You How This Actually Works.
Okay, so in finance, we use ratios to understand the health of a business. Let’s apply the same thinking to ourselves.
Measuring Liquidity: Can You Meet Immediate Demands?
In finance, liquidity ratios tell us if we can cover short-term obligations. The personal equivalent would be:
Current Energy Ratio = Available Energy / Immediate Demands
Are you waking up with enough in the tank to face the day? Or are you already running on empty before morning surgery? A healthy ratio is above 1.0, which means that you have more to give than what’s being asked.
Quick Recovery Ratio = Recovery Time / Depletion Time
After a difficult day or week, how quickly can you bounce back? If it takes a whole weekend to recover from Monday, your liquidity is concerning. That’s a red flag.
When these ratios dip too low, you’re in a liquidity crisis and may be unable to meet the demands of daily practice without borrowing against tomorrow’s reserves.
Measuring Solvency: Can You Sustain Long-Term?
Solvency ratios assess whether you can meet long-term obligations. For people:
Debt-to-Energy Equity Ratio = Accumulated Stress / Core Vitality
How much chronic stress are you carrying relative to our fundamental wellbeing? A high ratio means you’re over-leveraged. In the event of one major stressor, it could tip you into crisis. For example, a failed CQC inspection could be devastating for an overleveraged practice manager.
Interest Coverage Ratio = Joy & Fulfillment / Emotional Labor
Can the meaning you derive from work cover the emotional cost? If the ratio falls below 1.0, you’re not generating enough positive return to service the emotional demands. You’re operating at a loss. Read more about burnout here.
Measuring Profitability: Are You Thriving?
In business, profitability shows if you’re creating value. For people:
Return on Time Invested (ROTI) = (Meaning + Growth + Connection) / Hours Worked
I love this one. What are you actually getting back for all the time you’re pouring into practice? A declining return here suggests you’re working harder but gaining less. And this looks different for everyone, so really think about what thriving means to you personally. Be realistic.
Net Wellbeing Margin = (Positive Experiences – Negative Experiences) / Total Experiences
Are you consistently ending days, weeks, and months with more positive than negative? Or are you operating at a well-being loss?
Measuring Efficiency: Are You Using Resources Wisely?
Energy Efficiency Ratio = Value Created / Energy Expended
Are you achieving your goals efficiently? Or are you burning excessive energy on low-value activities? Administrative burden absolutely tanks this ratio for most clinicians.
Relationship Turnover = Number of Lost Connections / Total Relationships
High turnover, people not being able to get along internally, regular conflict, etc. Whether it’s staff leaving or partnerships ending, these could be signals of inefficiency in our human systems.
What a Health Check Might Look Like
If you were to conduct a quarterly “human audit” of your practice, you might ask:
Are our energy ratios improving or declining?
Do we have adequate reserves for unexpected demands?
Is anyone carrying unsustainable stress debt?
Are we investing in our asset base—training, relationships, recovery?
What’s our collective wellbeing margin?
The beauty of thinking in ratios is that it reveals relationships and trends. A staff member might seem fine in absolute terms but be trending toward insolvency. Or the practice might be financially profitable while running a human loss.
Investing in Assets, Managing Liabilities
Once you see the numbers, even if they’re subjective estimates, you can make decisions:
To improve liquidity: Build in buffer time in the staff day, reduce unnecessary commitments, and create flexible leave protocols
To improve solvency: Address accumulated stress through supervision, therapy, or career breaks. Reduce long-term obligations that don’t serve the individual or practice.
To improve profitability: Seek work that’s more meaningful, create a suitable delegation strategy for appropriate tasks, and invest in skills that foster career progression and income growth.
To improve efficiency: Eliminate bureaucratic waste, improve your systems, and protect time for the high-value work that actually matters.
The Bottom Line
We’d never run a practice without checking its financial health. Yet we often run ourselves into the ground without any objective, and measurable systematic check-in.
Ultimately, you are the practice’s most important asset. So maybe it’s time we applied the same care to our human accounts as we do to our financial ones.
Now, I’ve actually created an assessment tool based on these principles. It examines your assets, liabilities, and sustainability as a practitioner, similar to the financial ratios we use for businesses. Click 👉 here for details. You can print out a summary of the survey and take it to your next appraisal or use it for your personal reflection/journal.
What ratios would you add to the human balance sheet? I’d love to hear how you think about measuring wellbeing in your practice.
