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New sessionals, welcome on board

Dr Punam Krishan

punam krishan 3 x 2

If you’ve just completed your CCT and have opted to locum you won’t be receiving any other grand welcoming gestures or golden handshakes.

You are probably feeling like a fish out of water but guess what, you have autonomy over your work life for the first time ever!

I am confident that you will pick up the practicalities of sessional living very quickly, but let me share some nuggets of experience that I wish I had been told.

Never forget that you are an expert generalist, working collaboratively and equitably with consultants, GP partners and fellow sessionals. Nobody is your senior, and nobody is your boss. You have worked hard to earn your stripes, so do not allow yourself to be addressed as ‘just the locum’ or be taken for a ride.

It’s unsettling changing colleagues on a daily basis, but you must remain consistently professional and seek support when needed

Although trends are changing, there remains a historical perception – mainly held by staff and patients – that if you are a locum, you are less of a specialist. There is sometimes resentment directed towards sessionals by those who believe that locums are money hungry rodents, adding to the plague that is the GP crisis.

The reality, of course, is that sessional GPs are the solution, allowing partners to have annual leave, babies and sick leave, so be proud of the role you have undertaken to support practices and patients in need. It is time for us to change this attitude, so you must be the advocate. Make it your responsibility to correct those who misunderstand your role, educate those who remain ignorant and show them exactly why they are wrong.

As a sessional GP, the level of risk you carry is far higher than those fixed in practice so be mindful of your GMC good practice principles and ensure you are indemnified. You have a duty of care to your patients, but you also have a duty of care to your colleagues. Don’t shirk your responsibilities but don’t let others take the mick either. It’s unsettling changing colleagues on a daily basis, but you must remain consistently professional and seek support when needed because we are all working to provide care for the patients we share in common.

However, if you do not like the way you are treated in a practice then you must speak up and tell them why you will not be doing another session for them ever again. They need you as much as you need the work. It is a two-way process.

Starting out as a newly qualified sessional GP is nerve wrecking. There are many challenges within this role and it is most certainly not the cushy lifestyle many think it is. You are effectively managing your own business where you are the product, the marketing officer, the PA, the administrator, the finance manager, the complaints handler and everything else in between. This is all in addition to being a doctor, pursuing other interests, participating in CPD, oh and having a life.

It is essential to research what the competitive rates in your locality are. Connect with and ask other sessionals. Don’t be ashamed to ask and don’t feel embarrassed to charge. For every day that you don’t work, you don’t get paid. As a sessional, you don’t get holiday or sick pay, you don’t get paid parental leave and you have your own tax and pension contributions. You have to self-fund your indemnity – which is very high – as well as other professional fees. You also have your personal living expenses. Be realistic. Do not overcharge either, but be sure to stand firm on the fair price you set. We need to work in tandem and support one another, so don’t be shoddy or you’ll get a rep –everyone talks.

People often worry about lack of continuity of care when sessional. I have opted to work between two to three practices only, which gives me some continuity across varied demographics without additional paperwork. Nothing is impossible and yes, you can have the best of both worlds.

Finally, but most importantly, your health is number one. If you are well, you can help your patients get well. As GPs, we are the products of what we sell – better health. Plan your weeks, eat well, make time for exercise, prioritise your mental health and remember, sleep should never be compromised.

You have a long career ahead of you in an incredibly rewarding and fulfilling role, but you will only achieve the benefits if you take care of your own needs first. So good luck and enjoy being your own boss.

Dr Punam Krishan is a sessional GP in Glasgow

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Readers' comments (3)

  • Great article. Completely agree. I’m really enjoying being a sessional GP having been a GP partner and a salaried GP in the last five years too. I can see why most of the new GPs are opting for this career path at this current time as the conditions very much favour it.

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  • Well said, great article, locuming is great but boundaries are really important, maintain them, people will only respect them as much as you do.

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  • Vinci Ho

    Thank you for this insight article to let us understand how younger colleagues can cope with this career .
    The way I see this is simply a natural evolution of general practice in this country . The next five years will be interesting and no one should try to be a fortune teller . Do the right thing at the right place at the right time ( in history) , is always important. If any of these go ‘wrong’ , you know there are plenty of options . My motto for you guys is ,’ the government( in fact , country) needs us more than we need it’. Having said that , never say never. Life is a journey, not a destination , when you look back one day in the future .
    Look after your mind and body .
    Welcome onboard.

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