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At the heart of general practice since 1960

Moving practices the painless way

When I first met my wife, we talked of travelling the world. We would practise barefoot medicine in the sun, maybe on a tropical island. So after six years as a principal on the outskirts of London, I left my practice to join another on the Isle of Wight.

Entering a practice is now no longer regarded as a life sentence. It is common to move around and indeed to branch out of general practice altogether. The current GP shortage makes it easy.

Finding a wonderful new practice that will offer you a good deal is likely to be just as easy: but there are other issues.

If you move locally there will be obvious potential problems with your old partners. If you move to a different part of the country much stress will issue from factors other than commencing work in a new practice.

Telling your partners

This can be compared with removing a sticking plaster from a sensitive and hairy bit of skin. There are two choices: the quick yank causing a sudden yelp of surprise, or the slow pull from around the edges. There are pros and cons with both. Searching can cause prolonged stress and uncertainty in your existing practice. The quick yank approach at least has the benefit of presenting things as a fait accompli.

Now is the time to redefine yourself. Medical interests sometimes develop according to the talents needed in a particular group of partners. If you can afford it, take a sabbatical. You may never get the chance again.

I felt guilty about leaving my old patients. Dependent patients who consult three times a week realign rapidly, even before you leave. Patients who have consulted once only in six years, however, seem distraught and present you with bottles of champagne.

Practicalities

 · Scrutinise the new practice's accounts with your accountant. It is not always straightforward to compare practice accounts.

 · Check and renew the practice agreement, don't forget the old one is invalidated.

 · Are you a replacement partner or an additional one? As an additional one there are cash-flow problems, as it may be hard to work out income in an expanding practice.

Why you want to go

Be sure to ask yourself why you are moving. Many TV lifestyle programmes show the exodus of town dwellers seeking a better quality of life in the country. This was certainly the reason I made the move.

Of course you may be unhappy in your present practice because of the partners, workload, income, location or type of work. But even if you are moving from suburbia to the Outer Hebrides or an inner city to an isolated village, there will be more similarities than differences, so make sure you still enjoy being a GP.

All the heartsinks you joyfully left behind might have different names and faces, but you will certainly be seeing them again.

Swapping urban sprawl for rural practice needs careful planning, says Dr Patrick Wills

Tips for your move

 · Sort out partner's job and career

 · Establish new support networks: childcare, friends, young principals groups

 · Find schools, and consider timing move with start of new school year

 · Develop local knowledge of consultants and other services

 · Find somewhere to live and resist buying a wonderful new house until you are sure your new practice is the one for you

 · Plan for the sale of your surgery property and, after a mutual assessment period, the option to purchase in your new surgery

 · Plan cash-flow, especially if still running a home and renting, combined with long-distance house selling

 · Remember you will not qualify for a 'golden hello' or relocation expenses as an existing principal

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