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Suspicions over partner and practice manager's closeness

Case history

The practice manager is walking with a new spring in her step these days and appears to have invested in a whole new wardrobe. One day you hear her giggling behind her office door and shortly after the senior partner emerges without his tie.

You note that they have booked the same weeks for their holidays, although the senior partner's wife does not mention any holiday plans when you meet her in the market.

Is this any of your business, or the practice's?

Dr Peter Moore

'Either the senior partner or the practice manager should leave'

We do not have the right to pass moral judgments on colleagues but it is legitimate to step in when a partner's behaviour affects the practice. If our suspicions are accurate the situation is not tenable. GPs are under pressure with clinical work and have to rely on the practice manager. In financial and workload matters she must treat all partners equally. She must also have the respect of the staff. If our suspicions are correct this will soon be lost.

However, these are only suspicions. We need to know. A meeting with all the partners might be too threatening to the senior partner. One of the partners could have a quiet chat – one to one. This would need to be in protected time, preferably in the evening. If the other partners asked me to see him I would start by making it clear the discussion was on behalf of all the partners. The approach should be supportive.

As with any consultation, start with open questions. How is he feeling because some people have expressed concern? Is everything all right at home? As the discussion develops bring in objective observations, not opinions. Mention the holiday dates, for example, and the incident in the office. I could explain that I have no doubts over his integrity but others might misinterpret the situation. If he denies everything, gently suggest that, as there is no problem, should I meet his wife out shopping he will not mind if I mention the holiday.

If he admits to an affair and insists that he plans to continue, we need a meeting of all the partners. If he leaves his wife and moves in with the manager that is his choice and the partners cannot make a moral stand. But in that situation she cannot remain an impartial manager. Either the senior partner or the manager should leave.

I would need legal advice to ensure she does not sue for wrongful dismissal and to check the practice contract to see whether staff can be removed by a simple majority of the partners.

Dr Catharine Laraman

'What if they are massaging the

books – as well as each other?'

No smoke without fire, as the saying goes. Of course there may be an entirely innocent explanation for their behaviour but if I've noticed their extra-curricular consultations, chances are someone else has too. Maybe they are having an affair. Maybe the patients are beginning to gossip about it.

Maybe, even, the senior partner's wife is fully aware of the situation and is hoping that if everyone just minds their own business it'll eventually all go away.

This is the oldest dilemma in the book. Mrs Senior Partner is unlikely to thank me for raising my concerns about her husband – if I consider it to be my friendly duty – and if she's the last person to find out, I won't be on her Christmas card list if she figures I knew all along.

There's nothing wrong with meeting your partner for life at work, and considering how much time we spend there it's amazing we have any non-medical social life at all. There are problems, however, when half of the party is already married to a wife and, effectively, his partners (even if we're not prepared to have his babies).

Perhaps there is more of an incentive to become involved over the partnership issue. Hands up all those out there who have been part of, or witnessed, a practice split that occurred because of a marriage break-up within the practice. I may well be justified in being concerned about the potential workload repercussions if this all goes pear-shaped. In light of the suspected affair I might even be concerned about the practice manager's continuing impartiality. What if they were massaging the books (as well as each other?). Who handles the finances in the practice? Is now a good time to look at the balance sheets?

I'm unlikely to get a straight answer out of the senior partner and given that partnerships should be based on trust, I'd be inclined to hear the opinions of my fellow partners. Is this a one-off fling – or has the senior partner chased every receptionist in the practice?

If they were to forge ahead with a long-term relationship, how would we feel about the senior partner's new girlfriend as our employee? If there's a dramatic end to the romance, will the manager feel compelled to leave?

Of course, we might feel we could approach our partner as a friend and attempt to share our concerns with him.

Does he need time away from work to sort himself out? He might decide to alter his behaviour, but he may tell us to get stuffed. Whatever the outcome, if my suspicions are confirmed, it's likely to end in tears.

Dr Simon Atkins

'The situation needs confronting before things get out of hand'

In a sense anything that puts a spring back in the step of someone working in an NHS general practice must be a good thing, but the possibility of your practice manager having it off with the senior partner is probably taking morale boosting a little bit too far! This situation certainly is my business and that of the partnership, as this sort of thing could seriously upset the running of the practice. Already it seems the holiday rota has been affected and if other aspects of practice life begin to become inequitable, any sense of partnership becomes eroded.

More seriously, there's a secret alliance here between two people at the heart of decision making within the practice, our trust in their motives could therefore be destroyed.

And of course there's the effect any emotional fallout could have on the way they both work. Eventually his wife will no doubt discover their liaisons and things in his household will really hit the fan. Then – and this really would affect all of us – what would happen to their working relationship if they were to split up? I doubt if it would be improved. In fact it would almost certainly be unable to continue and we may therefore be in the unenviable position of looking for a new partner, a new practice manager or – worst-case scenario – both.

The situation would therefore need to be confronted before things got out of hand. And the facts need to be established before any action is taken because, although it's unlikely, it could all just be a coincidence about the holiday rota and so on.

Hopefully things could be resolved amicably. Although the biggest hurdle might be finding someone willing to confront them in the first place.

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