Salaried doctors: the real cost
Dominique Thompson, general practitioner, Bristol
Tuesday, 21 October 2008
Were they having a laugh? Those 24 practices advertising for a salaried GP in last week’s BMJ? When they sat down to write the ad, using words such as ‘dynamic’, ‘enthusiastic’, ‘enterprising’ and ‘self motivated’. Have these practices not yet realised that whilst the future of General Practice relies on exactly these qualities in our GPs, you will be far more likely to draw them out if the new GPs are made partners, not subordinates and employees of the current team.
The 12 practices advertising last week for a partner have clearly recognised that it would take phenomenal altruism to be motivated enough to help develop a practice and then see other people reap the benefits. Partnership means ownership of the problems and triumphs, being unafraid to meet the challenges, developing entrepreneurial ideas, and an investment of emotional energy and finance. That is what most GPs looking for new jobs seek. Salaried posts were only ever seen as a stepping stone on a career pathway by the younger generation, but now these GPs are stuck in jobs where few are asked their views on the running of the practice, and therefore few are motivated to get involved in the practice’s development. It is a huge loss of potential energy and creativity, through the short sightedness of current partners unwilling to share their increase in earnings.
This is short sighted for 2 main reasons; one, that if this scenario continues to be followed through to its natural conclusion, the scene will eventually be of a lone partner, working late into the night, mired in the management of the practice, because all his staff left at 5, as employees do. Secondly, work has shown that the actual cost of a salaried partner may be 27% more than their actual salary, with on costs for pension/ NI/ locum insurance etc. In other words, the £75,000 a year full time salaried doctor costs the practice £95,250 in real terms. Would a partner not be better value for money?
I have recently given talks to our local VTS GP trainees, at the end of their final year, as they look for work, post nMRCGP. There isn’t any. I have been shocked to hear that only 2 of the group of 30 have permanent posts, despite many more looking and applying. There was a real fear and desperation in the group as they asked me about finding work, and the lack of available posts. This is only going to get worse as our post graduate deanery, among many, increases VTS training places by 50% over the next 3years, following the government’s national workforce and training guidelines. The idea is to have many more GPs in post in 10 years time, to look after our ageing population. So if you are likely to be someone that these new young GPs are looking after in the future, ask yourself if you would rather they were feeling exploited and disappointed by their GP employers, or would you rather be cared for by dynamic, enthusiastic, enterprising, and self motivated GP partners whose value has been recognised by their colleagues?
The future is in your hands.