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It’s high time GPs moved out of the Dark Ages

Dr Cathy Welch

Dr Cathy Welch

I’m glad to see there is a move out of the Dark Ages of the ‘Medical Superiority Complex’, whereby GPs are seen as the only ones permitted to be the partners, or bosses, and everyone else is a subservient employee.

OK, maybe my language there is a bit harsh, but there is a taboo, unspoken cultural undercurrent which attributes power according to perceived status in an organisation.

‘Partner’ denotes responsibility, ownership, employer, the pinnacle within the organisation. There is an etymological power imbalance between ‘Employer’ and ‘Employee’, as there is between ‘Partner’ and ‘Non-Partner’ (be they salaried medical, nursing, managerial or admin).

Whether you believe this or not, there is plenty of anthropological evidence that historical cultural role-definitions do alter peoples’ perceptions of their roles and power within an organisation, and can limit their engagement and innovation for practice improvement, no matter how ‘inclusive’ the partners are.

We must embrace the skills and capabilities of essential non-medical professionals as equals in business

My first blog for Pulse (‘Why do we not let capable colleagues verify death?’) touched on the power inequalities between doctors and nurses, reinforced by historical dogmatic misconceptions which ultimately hurt us, our professions, and patients.

A good, successful partnership is not defined by clinical skills or knowledge, what degree(s) you have, or the title on your badge, but by the non-technical skills of communication, teamwork, leadership, business acumen, and the drive and innovation to improve the system.

GPs constantly complain of spiralling workload, compounded by increasing responsibility and financial pressures as businesses, yet continue to shoulder the weight like Atlas paying his penance.

If primary care is to continue to innovate, lead the way in accessible healthcare, and build a more realistic, equitable system, then we must embrace the skills and capabilities of essential non-medical professionals as equals in business.

 Dr Cathy Welch is a GP on the Isle of Arran, Scotland


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Readers' comments (40)

  • So...the apprentice is as skilled as the master, because that makes for a more etymologically consistent world. Great. Well done on that problem smoothed out

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  • Losing our status as the only full liability profession in the UK left since the Lloyds' names system went under would help. Unfortunately PMS/GMS can't be held in limited liability partnerships for some reason.

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  • Cobblers

    You stick to salaried Cathy. Clearly being a partner would upset your view of the world.

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  • Partnership works on shared responsibility and shared risk Cathy. Let's see how that one goes.

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  • The point, which I appreciate my not be completely obvious, is that a practice is more than Doctors. Why should it be assumed that a 5year post CCT GP is any more qualified for the responsibilities and planning roles than a nurse of 20 years? Does MRCGP make you any more likely to stay in that practice as a partner than a nurse, or practice manager. Does MBChB give you automatic right to be the boss?
    But it is interesting to see dinosaurs creeping out from the dark corners when they see their dominion threatened.

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  • Nurses and managers are as key to practice development and management, but apparently some still think that they are not worthy of the challenges and risks of partnership.

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  • AlanAlmond

    A partnership is about equals working together as a team. I don’t really understand where your coming from, sounds a little ‘chip on the shoulder’ to me. I can’t see how two people with completely different training could ever consider themselves as truly equivalent. That said I’ve never really got my head around the concept of the Partner vs salaried GP thing. It’s caused a heap of unintended consequences which general practice has yet to really get a grip on. But back to the article...I think your a little confused, but maybe it’s the salaried GP thing that’s clouded the your thinking. See there it is again..Partners vs Salaried - who ever thought up the whole salaried GP idea has a lot to answer for. You see Salaried GPs and Partners do have equivalent training ...and there is the rub.

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  • Macaque

    LOL! 'Dinosaurs creeping out of the dark to comment!

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  • David Banner

    An odd time to write this article, given that older partners are ditching their contracts and retiring in their droves, whilst younger GPs won’t touch partnerships with a barge pole. And with the issues of last man standing, unlimited liability, decades long leases, property ownership etc etc, who could blame them? Partnerships are suffering a long slow asphyxiation, they’ll be gone in a generation, so your dream of equality is just around the corner.....none of us will be bosses, we’ll all serve under the (not so) benign dictatorship of Branson et al.

    To quote Neil Peart, when the little maples complained that the mighty oaks were hogging all the light.....”Now the trees are all kept equal, by hatchet, axe and saw”

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