Common problems for new GPs
Struggling with a heavy workload
Each of the partners keeps on giving me extra work to do and I don’t feel I can say no. How should I handle this situation?
Dr Fiona Cornish
You will probably want to do everything you are asked, but it is vital that you do not become overwhelmed, especially if you are being dumped on. Minor niggles must be brought up and discussed early, before resentment builds up.
I would recommend that any new GP asks to have a designated partner as a mentor. There is so much to learn about where things are kept and how the practice operates as well as dealing with the medicine. You may find that all tasks take longer than expected, just through being unfamiliar with the processes. Your mentor should be the first port of call if you are struggling, because your colleagues are unlikely to have the time to make your life comfortable, let alone to do their own work. Ideally the issues you are having with your responsibilities should be brought up at a practice meeting, however daunting this seems.
Any salaried GP contract should specify exactly what you are expected to do. Having specific finishing times is impractical, given varying consulting speeds, but it would be worth clarifying whether you are expected to do, for example, QOF work.
As a new partner, however, it is more difficult to specify your hours, because as we all know, workload has mushroomed.
Develop a rapport with all your colleagues, including the practice manager, so that you feel comfortable raising concerns early. Most partnerships want you to settle in happily since recruitment is at a crisis point. It is in everyone’s interest to ensure that you are happy and plan to stay.
Dr Fiona Cornish is a GP in Cambridge
Confused about which path to take
You are fortunate enough to be completing your training in a seller’s market. You should be able to negotiate a job that is right for you and so long as you work hard and efficiently, many practices will be keen for you to join them.
Although locum work is flexible, it can also be seasonal. Demand is high around Christmas and in the summer holidays, but less so during November and February.
Sessional work can also be quite solitary, with a high proportion of on-call days and little continuity. Although earnings can be high, as a self-employed professional you will usually have no holiday or sickness pay and the lack of regular peer group support may put some people off.
Entering a partnership straight out of training is certainly an option, but some new partners do find that the registrar post has not prepared them for 12-hour days of intense work. But completers who have previous medical or life experience, or financial obligations, may find partnership is the quickest route to a good income.
For many, a salaried post will be the right compromise between job security, continuity of care and freedom from the management and business side of general practice. As it is so hard to recruit partners now, many practices are offering salaried-plus posts with a view to partnership at a later stage if you settle in well.
Dr Harry Yoxall is medical secretary of Somerset LMC
Risks of taking over another partner’s list
I’ve just joined a practice and taken over the personal patient list of a retired partner. I need to update the prescriptions to current guideline standards, but what are the medicolegal risks? How can I avoid complaints?
Dr Laura Edwards
I would suggest that in your first few consultations with new patients you need to work on introducing yourself and developing that bond of trust.
Deal with their agendas first to show that you care. You will need to make a professional judgment on each patient and the risk they face on their current medication regime. If you change the medication too early, without their acceptance and trust, they may not take the medication anyway – drugs left inside packets definitely don’t work.
Guidance will often state that patients who are stable on existing regimes don’t need to change their current habits so avoid any unnecessary battles. Changing drugs can mean new side-effects and unfortunately, since you are the new doctor, the patient is likely to lay the blame at your door.
Choose your timing – once you have developed a bond of trust, offer a medication review or mention that there may be something better now in light of the latest research or guidance. Believe in yourself and build up a support network around you to talk through any difficult cases.
Dr Laura Edwards is a GP in Locks Heath, near Southampton, and medical director of Wessex LMCs