Introduction
A partnership is a very coveted role in General Practice and rightly so. Uneasy lies the head that wears the crown.
I had an interesting conversation about being a portfolio GP and Partner. Most surgeries in the UK still operate with a partner(s) at the helm of affairs. How a partnership is structured varies from practice to practice. Are you expanding your practice partnership? – The answer is a reluctant yes/no. Here’s why.
Understanding the road to Partnership
If the number of patients at your practice doesn’t change often, you’ll likely have a good handle on how to take care of them over time. You know how many people you need to handle any increases, like when more patients come in during the winter. You might need different healthcare professionals, such as advanced nurse practitioners, paramedics, and first-contact physiotherapists, in addition to GPs, to meet those needs.
It’s really important to figure out when to bring in a locum GP, whether it’s for a quick fill-in or for a longer time like when a colleague’s on maternity leave. You can also help your surgery run smoothly by telling patients when you don’t have enough staff available. This helps avoid overworking your team and keeps things safe. Also, if your surgery is in an area where other surgeries aren’t closing down, you won’t suddenly have too many patients to handle without enough doctors.
On the other hand, a practice with an expanding patient list size, or retiring partners might readily open up partner roles.
First Salaried, Then Partner
Right now, some surgeries might give you a salaried job with a view to partnership in the future. Others don’t offer this. The kind of job that offers a salaried role with a chance to become a partner can be better for staff retention. Curiously, you can ask how long it usually takes for their salaried GPs to become partners to see if the timeframes are practical. It varies from person to person. What is more important though, is the relationship you develop over time.
When you start working in a salaried role in a chosen surgery, it offers you a means to understand yourself and your colleagues. It’s also a good way to consolidate your experience of the GP trade, A big part of it is trusting your own decision-making and those of your colleagues. When things get tough, you see how people handle stress and do their best work. This kind of experience gets you ready for a bigger role as a partner in the surgery. It’s pretty clear that keeping this kind of connection can be tough as a temporary GP.
Some surgeries immediately offer partnership positions, and it’s okay to pay attention to the details of this offer, especially if you’re new to being a GP. Accepting a partnership too soon can be like taking a chance without knowing what to expect. Although some GPs have become partners right after finishing their training and had good results, it’s still a good idea to do some careful research. For example, Are you starting on a parity salary? Are you buying into a partnership with early retiring partners who you may need to buy out their stake in a building?
Generally, the advice for a new qualified GP is to be open to partnership roles. Shop around if possible either as a locum or a salaried, and when you decide to expand your role and responsibility, do so pragmatically. See BMJ’s guide to partnership here.
Becoming a Portfolio GP
Having a portfolio role ensures you perform a variety of what you love. This keeps the passion for your job burning and your joy in work alive. You need both to play the long game.
Most GPs enjoy doing their regular work and following their contracts closely. They want to provide lots of appointments and use all available resources to keep their practice financially stable in the long run. However, there should be a balanced view of how to deliver the GP contract. You need to think creatively and find extended roles to bring additional income to the practice. For example, trainer role, teaching, dermatology service, frailty service, research and trials, and minor surgeries among other things..
All these services require passion and dedication from you and your fellow partners to be able to apply entrepreneurial knowledge to meet these goals. Some might take on more sessions for a brief period to meet these types of roles. This means that the additional income into the practice can pay for an extra hand for your routine contract work.
Fusing Portfolio Work and Partnership
Partners look out for this type of contribution to the GP business while also prioritising a great working relationship. Read our article on how to build meaningful relationships at work here.
A successful portfolio GP stands out by thinking creatively and collaborating effectively with colleagues to harmonise your expanded responsibilities. A salaried GP might be able to earn the relationship currency to develop a portfolio role as do partner colleagues.
You might like being a calm GP who only works their regular sessional hours. Or you might prefer to be a GP who fills in when needed and then leave. You can choose any of these options and take full advantage of them. However, owning a business, practising flexibly, and earning more through partnership remains an excellent and attractive choice.
Working as both a portfolio GP and a partner can give you a good balance between your job and personal life, and it also has the potential to have significant financial rewards.
We hope this inspires you to find what drives your sail in this challenging GP profession.
