Choosing the perfect partnership

Partnership is a commitment not to be taken lightly, says Dr Bill Irish

When I was a GP registrar there was a cynical joke doing the rounds. ‘What is the difference between a GP partnership and a marriage?’ — ‘a partnership lasts forever’. Partnerships are long-term commitments, difficult to extricate yourself from and on occasion just as intense as marriage on the relationship front.

Finding a vacancy
Partners in general earn considerably more than salaried doctors, and this encourages practices to go for the salaried option when recruiting new doctors; consequently, there are fewer partnerships on offer today than a few years ago.

Under the ‘new’ GMS contract, income is now practice based, rather than practitioner based, so a new partner generally is not appointed unless there is a genuine need for someone offering a particular skill above and beyond basic clinical work.

Traditionally, partnerships have been advertised in the GP weeklies such as GP or in the BMJ.

Increasingly, however, practices are advertising locally, and often informally. Current or recently employed salaried doctors and locums are normally targeted first, but inevitably the word soon spreads. Keep your ear to the ground, try to work in any likely looking practices and phone practice managers if you hear of any rumours.

Is it the right practice?
Many years ago, my own trainer gave me an important tip about applying for partnerships: if you don’t get an interview there is probably something wrong with your CV.

If you do, but still don’t get the job — it was probably the wrong practice for you.

Whatever you feel about money, location or premises, there is no doubt that the clincher for most people is going to be the general ‘feel’ of the practice. Ask yourself whether you would be happy working there for the next 20 years. Consider whether you actually like the other partners. Are they motivated by money?  How do staff interact with each other?

Ideally try to do a couple of locum sessions at the practice, but if this is not possible talk to as many people as possible who have.

A useful source of information can be the local course organisers. Try to visit informally during a working day.

Tailor your application
The fact that you are a great clinician is taken for granted at this level. What really might make the difference are demonstrable additional skills in areas such as management, IT, medical politics or perhaps a GPSI level clinical interest that could potentially bring in additional income to the partnership. Tailor your application to highlight those that look relevant to each practice.

Interviews are usually in several stages. Often there is a supposedly informal opportunity to chat to the partners and practice manager.

Questioning will assess how well you would fit into the partnership team, and tease out skills that will make you an asset to the practice. References are always taken up, so do make sure that these match with the areas you have highlighted in your application.

Talk to an accountant
Being a partner is very remunerative. Typical earnings in my part of the world are well in excess of £100,000 per annum for a full-time-equivalent partner. This will be higher for larger, business-oriented practices, and for those with substantial numbers of dispensing patients.

To plug into such a good income stream you are going to need to commit all of your energy to the practice together with a large amount of your own cash. Loans of £250,000 or more are not unusual in this context. For most young doctors finance on this scale is unfamiliar territory.

Talk to an accountant who specialises in medical work. Insist on having copies of the last three years of accounts from any practice you are considering joining, and do not sign or agree anything until your accountant gives you the all-clear.

You will also want to take independent advice on valuing the surgery and the practice agreement well in advance of finally accepting any post. It is usual to spend six months or a year on a probationary basis, usually on a fixed, smaller share of the practice profits. This gives both parties chance to extricate themselves before things get too difficult. 

Dr Irish is a GP and associate director of GP education at Severn and Wessex Deanery

Learning points

How best to choose a partnership 

  1. Identify vacancies locally as well as through the medical media. Try to work in any likely looking practices and phone practice managers if you hear rumours of a partnership vacancy.
  2. Find out as much as you can about any practice where you are thinking of becoming a partner. Do locum shifts, or visit during the working day.
  3. Tailor your application to highlight management, IT or other skills that you think the practice might require.
  4. Talk to an accountant who specialises in medical work. Ensure they see copies of the practice’s last three years of accounts before you sign anything.

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