The first part of this guide discussed the challenges faced by GPs starting work in a GP partnership, including the local setting, dealing with clinical staff and patients and other considerations when starting at the practice.
The information in this guide is best used as a template or a checklist that can be adapted and then revisited on a regular basis to check how you are getting on and help you identify possible areas to work on as you go forwards.
This part of the guide looks at working with the other GP partners and how to make the new partnership a success. The final article focuses on working with the practice team and your CPD.
Understanding the partnership
When you join the patnership, expect quite well-established partnership dynamics with functional (but also, not infrequently, dysfunctional) sides. These will have formed over time and are often complex and impossible to describe or explain.
Note personalities, reputations, role hierarchies (whether open or not) and levels of experience. Typically, there will be a number of unwritten norms and rules for you to discover.
Gently explore and consider the motivations of the other partners regarding their work (e.g. mainly business focussed, altruistic) and their current true stress levels.
Beware of readjustment outcomes in the partnership (for example due to a previous partner leaving, reshuffle of hierarchy, possible appearance of 'skeletons in the cupboard'), with potential for conflict.
Take note of any signs of irritability, anger, fear, confusion or resentment (but also respect and admiration) among the partners and other members of the practice team. Avoid forming premature alliances with anyone and be mindful of anyone trying to ally with or against you.
Define duties and expectations
Do you have an agreed trial period before committing to the partnership (with financial buy in and full legal responsibility, etc) and/or a working up to parity arrangement? Before you start at the practice make sure everyone is clear about this and what this involves at each stage.
Define your duties and the practice's initial expectations of you. Take this at an easy pace at first, because the quantity and complexity of your tasks will usually grow with you.
Ensure that workload is equally and fairly distributed from the start (this includes possible extended hours, private work such as medicals or insurance reports etc.) There is a fair possibility, that at least one partner may be struggling, or may not always lift their share of work for one reason or another.
It may turn out that your number of sessions (and/or their distribution) need to be adjusted after a while; do not feel bad about it as this is unlikely to have been predictable. If you find you (or everybody else) could really to with some protected time for projects, administration etc, do consider voicing this, rather than ignoring it.
Developing your role in the partnership
Adopt and follow current practice procedures before you consider making any suggestions for substantial change. Even when people say that they 'welcome change', they usually do not want it to happen overnight. Ensure you choose the right time, place and person or group to propose any changes to.
Regularly gather, accept and implement feedback. Reflect on areas of difficulty or disagreement and consider options and possible compromises.
Expect to make mistakes at first (probably plenty of them). Acknowledge and learn from them so that ideally, they do not happen again.
Adapt to the pace of the job in the new setting. Show initiative. Be punctual, but watch your amount of overtime - and that of your colleagues.
Don't try to show off - you did a successful interview. Aim to underpromise and overdeliver with the work you take on. Be okay to pace yourself initially. Do what you say you will do - if you can't, make that known early enough not to cause problems.
Regard your new partnership as a long-term relationship and work on it steadily, not radically.
- Dr Jacobi is a GP in York