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Finance diary, March: How to avoid becoming a dysfunctional practice

It is vital practices pull together and partners delegate effectively. Bob Senior advises on the warning signs of problems in store

Tough times lie ahead and teamwork will be essential if practices are to ride out the storm. Dysfunctional practices, where GPs fail to delegate effectively or where partners fall out, will only make a bad situation worse.

Unfortunately I have noted an increasing number of practices where solicitors have been called in to sort out partnership disputes (usually at great expense) or where profits have fallen so much that partners are deserting the ship.

I have noticed three common signs of trouble, so if your practice is showing them, now is the time to change.

1 GPs who micromanage

Although responsibility for patient care ultimately rests with the doctors, GPs have to work as part of a team. Clear expectations must be established of what will be done by each team member, training given, and robust processes established to ensure work is completed.

GPs should not be permanently checking up on staff. Nurses need to be trusted to operate within their remit and practice managers should be allowed to get on with running the practice.

2 Partners not talking to each other

In a busy practice it is not uncommon for partners to comment that they have no time to talk to colleagues. This can be overcome with effort, perhaps by moving practice meetings occasionally from the traditional lunchtime slot to first thing in the morning or in the evening. Unless partners devote time to the practice they could find it collapses around them.

But if partners are not talking to each other because they have fallen out, this must be resolved. If it isn’t, things go downhill quickly and all partners feel the effects. In my experience, if partners are unable to patch things up, one of them needs to leave the practice promptly. Allowing the situation to drag on will mean solicitors have to get involved further down the line.

3 Partnerships with no succession planning

Many GPs are struggling to cope with what is happening now, let alone plan for the future. But with many now in their 50s and young doctors changing their attitudes to partnership, practices need to tackle succession planning now.

Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at RSM Tenon

Raising finance to pay off a retiring partner for their stake in the practice is increasingly tricky. In February’s column, Bob Senior advises on the options for managing premises costs when partners retire.

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