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At the heart of general practice since 1960

The things I miss most about partnership

Dr Shaba Nabi

It’s a year ago now since I hung up my partnership cap and became a salaried GP. There’s no doubt I am infinitely less stressed, exhausted and grumpy than I was as a partner. But it wouldn’t be fair to paint a rosy picture of life on the other side without acknowledging the positive aspects of partnership.

So I thought it would be a good idea to offer a more balanced view by reflecting on the things I miss about being a partner.

I miss the mafia… I mean family

Partnerships are just one big, happy and dysfunctional family. Like all families, even though they don’t always agree with each other, they look out for each other. And what with all the meetings, strategising, planning and socialising, it sometimes felt like I saw more of my partners than my actual family.

I miss having a voice

Even within the most inclusive and collaborative of practices, it is hard to steer the direction of travel unless you’re a partner. So whether a fully triaged access model has been foisted upon you, or you have been forced to stare at ugly blue curtains for the rest of your life, it’s frustrating no longer having a say.

I miss the innovation

Many large-scale quality improvements have been implemented through partnerships: mergers, overhaul of an access model, recruitment of alternative practitioners, and while some of these innovations have been driven by current climate, they still pave the way for new ways of thinking and working.

I miss being in the know

Even the most apolitical GP partner has an idea of what’s going on within the CCG and NHS England. In spite of being an LMC board director and a CCG clinical lead, there are still numerous things I am unaware of locally. So now I have to actually read a lot of the news in Pulse, rather than picking it up in meetings.

I miss being the boss

My kids think I’m bossy, probably for good reason. Anyone who knows me is aware I can’t sit back if I think something can be improved. I hold leadership positions in all my portfolio roles, so it feels a little strange to be taking a back seat in my clinical role.

I miss the cause

Fighting for partners’ rights in my LMC role is like being a rebel without a cause. I still fight against the work shift from secondary care and funding erosions, even though they no longer impact on me directly in the way they used to.

I miss the street cred

Let’s face it – huge kudos comes with being a GP partner. And in the present NHS crisis, the respect due to partners is akin to that accorded to the SAS or to a doctor working in an Ebola outbreak: people know the role requires huge grit and determination and are a little bit star struck by it.

So, maybe one day I will don that partnership cap again. But one thing’s for sure, it will be have to be in a culture where the respect mentioned above is matched by appropriate remuneration for all the dedication and sacrifice.

Somehow, I don’t think such a cultural shift will happen under Tory leadership, however chastened it may be.

Dr Shaba Nabi is a GP trainer in Bristol 

 

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Readers' comments (9)

  • Azeem Majeed

    Thank you for your article Shaba.

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  • I miss nothing, nothing at all
    I don't miss the huge responsibility of running a practice in englands poorest area that could not recruit.
    I don't miss the fact that I was viciously blamed for things that werea ctually results of failed politicians.
    I don't miss not having days off

    im salaried. im a good and thorough doctor.

    but my only plan is to cut my hours as soon as I can financially.and leave this stinking mess created by HMG as soon as I can

    really nasty blame for the front line for political and funding failing is the name of the game

    partner? never again

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  • Partnershio sucked big in the early 2000s when I could have been persuaded. It just got exponentially suckier...

    I use that last word in order to resonate with Dr Nabi s notion of partner-as-street-cred....laughed, I nearly turned my ENT mirror headband around backwards

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  • Cobblers

    I am truly lost for words at such profound and misplaced retrospection.

    It's like having a large blood sucking bull leach attached to your vitals and then with some pain removing it. You then reflect at how much better you feel without it but complain that you were just getting on first name terms and it really, really wasn't that ugly.

    I left GP Principal almost a year ago. I felt free. Free. Free!

    And here I am a year later and I am enjoying my medicine and my life. I have become unburdened. The leech has gone.

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  • Apart from loss of pride, I miss very little.

    I worked with lovely patients and colleagues, I was only partner for a few short years and could not manage that!

    However the paycheck in Pharma makes up for it and the hours are equally long but nowhere near as stressful!

    I don't think the NHS can survive without GP partners but it appears like a losing battle unfortunately because of short-sightedness from NHSE and other political players

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  • Vinci Ho

    There is a song in Katy Parry's new album , 'Miss you more' I like very much .
    This is probably how you feel , Shabi , as the chorus goes,''I miss you more than I loved you (I wonder what we could have been?)''

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  • This makes interesting reading, Shaba, thank you.

    The having a say and being the boss seems, in hindsight, to me like an illusion.

    I'm enjoying the view from various different perspectives. I'm enjoying having conversations outside the room with the bars. Proper conversations over lunch, or coffee, without a written agenda.

    I'm enjoying being able to ask GPs, 'How are you, really?' and having the emotional energy to listen.

    I've enjoyed moving from GP partner failure into GP partnership survivor and finding camaraderie and innovation among those who also escaped their rooms. I'm enjoying saying, 'I'm a GP, but no-one's perfect' or 'I'm a GP by background'.

    I'm enjoying the concept that you don't have to be a GP forever, that my 100 year life can be defined by other roles.

    It has taken lots of adjusting but when I wake up from a nightmare about partnership stuff, I feel so relieved it's no longer actually real.

    I know we need partners, but that's for stronger and better women and men than me.

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  • (almost)GoneDoc

    At the stage in my career that it would have been appropriate for me to look to get a partnership it seemed like a really stupid thing to do - so I decided not to. In retrospect, all in all, I feel this was a good call. The problem arises however that with around 20 years left ahead before I can hang up my stethoscope, life as a salaried GP is becoming increasingly frustrating and dare I say it, boring. Where do you go as a GP if you aren't going to be a partner? A manager with the CCG? An Appriaser? No thanks. Leave the country? I can't. Have kids? I don't have a uterus. This dead end salaried GP has no partnership street cred to fall back on, just deep regret at becoming a GP in the first place, just at the point when the whole concept of a GP career seems to be going down the plug hole. I used to find commenting here kind of cathartic but more and more I realise it's been a way of telling myself I need to stop seeing myself as a Dr ...it just makes me angry. It's time to give up the Dr pretence, accept it all for what it is, put it all down to experience and do something else. I hear-by promise to myself I won't be posting anymore. All the best and cheery by.

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  • Really good read , well done Shaba

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