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Should I apply for a partnership or a salaried position?

I am a newly qualified GP and I’m wondering whether to try for a partnership in a practice or whether to seek work as a salaried doctor. Can you give me some advice?

GP, East Midlands

I am a newly qualified GP and I'm wondering whether to try for a partnership in a practice or whether to seek work as a salaried doctor. Can you give me some advice?

GP, East Midlands

Four years ago, most advertisements for GP positions were seeking individuals with a view to partnership. Now the situation is reversed and most positions are salaried. There may be a redress in the balance over the next few years but it is likely that salaried positions will continue to predominate.

So, what are the issues for you to consider in making your choice right now?

Partnership is, in essence, a business relationship

Partnerships must exist with a view to profit according to English Law. Partners are jointly and severally liable for all issues relating to the practice. These include any liabilities for money that may be demanded from the Practice. This means if your partners default, you could be liable for their share of the debt as well as your own. So partnership involves risk in all areas of the practice business life - from building a thriving practice to being an employer.

Partnership is a challenging relationship too.

Once you are in a Partnership you tend to be in one for many years. So relationships with partners matter hugely. Any disputes can be an uncomfortable experience and you must consider how you will cope with this relationship when things are going well or when things are going badly. When partnerships work well - and there are a huge number that do - it can be a great and fulfilling experience.

A successful Partnership requires a long term commitment and an investment of your time and potentially your money. As an employee you will have greater flexibility to develop your career in different directions. You can move practices or jobs easily or engage in new projects.

There is less risk in being employed - but potentially less to gain as well.

In salaried positions, you do not take on the risk of owning the business. Your salary will remain constant regardless of the financial state of the Practice. However, that salary will not rise if the practice has a better financial time than expected (unless you are able to negotiate this separately).

The employment rights that you gain as a salaried employee create less financial risk for you. As an employee, you can benefit from the many and various rights that employees enjoy such as national standard maternity leave and holiday pay. These would have to be negotiated separately in partnership deeds

Being salaried frees up your time to focus on your priorities

Not everyone wants to have the commitment and responsibility that comes with being in partnership. Many doctors now enjoy the ability to come in to work and focus purely on clinical work. Part time, fixed hours and flexible hours are all now available. These arrangements are both family friendly and enable a work life balance. There may be more opportunities for extended study or pursuing outside interests. Being salaried can give you more flexibility

Ostensibly it may seem that you are doing the same job regardless of who you work for. On the contrary, who you work for matters a great deal. There is increasing choice, from local partnerships to large GP provider companies. As these providers compete with each other, employment opportunities will improve and options will become available to be involved in business and clinical developments.

From a pure financial perspective, being a partnership probably offers more money. But being salaried will leave you with time to earn money from other sources such as Out of Hours. Its benefit over Partnership is that every hour you work will be remunerated.

It remains to be seen what the earning potential is of those doctors employed by companies who have talent in both business development and clinical development. It is likely that their earning potential could outstrip that of GP partners.

My advice is to do your research into local practices, think carefully and talk to both partners and salaried doctors. Further useful advice is also available on the BMA website.

Rory McCrea

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