Transitioning from Salaried to Partner: GPs Have YOUR Say!


Answering some of your biggest questions on the transition from our GP clients.

We asked, you answered! It’s no secret that the transition from salaried GP to GP partner is not an easy one to make. As if the medical field weren’t already challenging enough, GPs new to partnership find themselves suddenly facing a whole new set of challenges for which their medical training alone has left them woefully unprepared.

So, we asked you, our GP clients, to have your say and speak up about many of the common issues you face in this unique transition. And you did NOT disappoint! Here’s what you said:

1. The change in identity from “just another member of the team” to team leader can be uncomfortable and difficult to navigate.

In contrast to being a salaried medical practitioner—where you have a fairly clear-cut set of individual responsibilities laid out for you as an employee, for which you are fully trained—GPs transitioning to partnership must take on the unfamiliar role of both business owner and boss to former colleagues, all while facing down the novel obstacles that come along with running a business, directing employees, and learning how to function in equal partnership with fellow GP Partners.

One minute you’re just another employee on staff and the next minute you’re everyone’s boss! The sudden change in relationship with the other members of the practice and staff requires the setting of new boundaries that reflect the new hierarchy. But doing so while maintaining healthy, positive relationships with all members of your team is much easier said than done and can feel uncomfortable for everyone involved.

“When you are in medical training you really only have to think about yourself. And even when you’re salaried, you can really just think about yourself and what you’re doing. But now, [as Partner] you have people coming to you saying ‘well, you know, we’re really stressed at the minute, what are the partners going to do about XYZ? Or about shortage of the nurses? Or why have such and such had a pay rise and I haven’t had one?’ And you think ‘these are actually questions that I’ve now got to have an answer for’ and, actually, a lot of the time I don’t!”

2. Time management is tricky!

In addition to the clinical work of caring for patients, a new GP Partner is now confronted with all of the added responsibilities of running a business, with administrative tasks and constant interruptions vying for her or his attention every minute of the day. It’s like working two full-time jobs at once! From staff questions and HR, to business strategy and financial planning, everything must somehow fit into working hours lest the hapless new GP partner find her or himself robbed of evenings with family and friends as they are forced to bring work home at the end of each day.

“You have to pick up all that slack and then you don’t have the time to do the other work. Whether it’s CQC or dealing with all the complaints, there’s this hidden workload and big decisions to make. You’re not just thinking about your own workload and how it impacts you, you have to think about the 40 or so people you’ve got employed at the practice.”

This can make the search for a healthy, satisfying work-life balance begin to feel like a mythically hopeless quest. But it doesn’t have to be! Learning to protect your home-life from your work duties is your best defence against burnout. Therefore, learning how to manage time efficiently and increase both your own personal productivity, as well as the effectiveness and productivity of your team, is absolutely essential!

3. Business strategy planning means building the confidence to “make your mark”.

So, you’re a business owner now. How do you want your business to run? What should your business priorities be? What do you want your business to look like five years down the road?

As Partner, you must now take part in deciding which direction you’d like to see the practice go and designing or choosing the best strategy for how to get there. You have your own unique perspective and skill-set to share and there is learning involved with developing the ability to bring your ideas to the table in a productive manner, as well as learning how to feel confident in your decisions without stepping on the toes of the other Partners.

“I think it’s really important for each Partner to offer something a bit different. I don’t think a partnership would work if we all came to the table with the same skill set offering the same things… All I have known to do is just bring to the table what I know I can do and what I enjoy doing and what I’m reasonably OK at doing…. That’s actually the great thing about working in a big partnership, and we’re really lucky, we all bring up slightly different skills and that’s really important when looking to who’s going to join next.”

Which brings us directly to…

4. You have to learn how to work well with the other Partners.

Disputes between new Partners can be fairly common, as everyone often seems to have very different ideas of the best way to manage a practice. All Partners must learn how to compromise with one another and work together to come to decisions with which all can be happy. And yet each Partner must still be able to put her or his point across and feel heard in the process.

This means learning to work with people in a different way than you have before. As a salaried GP you weren’t required to make decisions WITH anybody else. If you said to a patient “this is what I think you should do” they tended to listen to you because you’re the expert. Whereas, with Partners, you are all equal experts and now you’ve all got to listen to each other’s suggestions and work together to decide the best way forward.

“Becoming a Partner involves investing a lot of your own time and money into the practice. The role becomes more than ‘just a job’ and, rightly, Partners care passionately about any decisions being made about the business. Whilst it is rewarding to work alongside colleagues who care about the business as much as you do, it can also cause friction when people have differing ideas about the best way to move forward. Learning how to handle those difficult conversations can sometimes be challenging.”

This also means that before you actually take on the new role as Partner, you need to make sure that your partnership agreement is in place and that it clearly addresses all of the ins and outs and legal bits and bobs of your new role and everything involved. This includes what percentages you are owed as well as establishing ahead of time how certain situations will be dealt with (e.g. parental leave etc) so that, if anything difficult should crop up in the future, everybody is already really clear on what has been agreed to and you know exactly how to proceed rather than being left floundering in the moment.

5. It’s either learn non-clinical skills or bust!

As a physician, you’re already well equipped with the clinical skills necessary to effectively practice medicine as a GP. Unfortunately, the non-clinical business skills required to successfully run a practice were not included in your medical training—though this does not render them any less essential to your success as a Partner.

There will be things you’ve never really thought about before on which, suddenly, you’re being asked to have an opinion! Things like financial planning, legal compliance, business management, strategy planning, leadership, etc. Many new Partners don’t know what to do and feel at a loss as to how and where they can acquire these skills quickly, so as not to be left in the dust.

“The whole idea of running a business sort of becomes your responsibility and we don’t get training for it. So, when we have our annual account meetings, we now get spreadsheets and forecasts and projections and prior to now I’ve never seen these before. And, so, you have to just learn what they mean and it’s almost like trying to do a part of an MBA while you’re trying to do all the rest of it.”

Fortunately, the NHS has taken notice of this plight and currently offers funding for new GP partners wishing to learn new, non-clinical skills—as well as to become better equipped to face all of the unique challenges listed above that come along with transitioning into GP Partnership—to participate in programmes such as the [New to Partnership Programme] we offer here at Xytal.

“I definitely don’t have the same kind of business head as some of the other partners do. I’m hoping that I can develop that skill for sure…. We have very little training, if any at all, on that side of things. So, I’m really excited to kind of develop some skills in that area.”

If you are interested in finding out how we can help to make your transition to Partner a smoother, more painless process, please don’t hesitate to reach out. We would love to be of assistance!

Xytal is one of the leading British consultancies in the health sector. If you found this article beneficial, you might also consider checking out our New to Partnership Programme.

We asked, you answered!