Considering a portfolio career? Think about the medico-legal aspects

GPs are finding that portfolio careers are helping to alleviate the stresses and potential burnout in general practice. MDDUS medical advisers and GPs Dr Natasha Castellino and Dr Roopinder Brar discuss issues GPs need to consider when taking this route.

General practice is professionally fulfilling and a privilege to work in but there is no doubt that it comes with a unique set of challenges. Patients’ needs have evolved, and with this, so have their expectations of the service that is provided, leading to increasing pressure and challenges for GPs – managing workload and capacity, social media scrutiny, increasing clinical complexity and maintaining their own wellbeing while navigating frontline demands.

This in turn can result in emotional fatigue and burnout, impacting morale and confidence at any stage of a clinician’s career. In view of this, some GPs will consider other opportunities that allow them to use their skills, knowledge and experience so they can continue to work and contribute to patient care.

For our newly qualified colleagues, those returning to practice or joining primary care having worked abroad, the learning curve can be particularly steep. Newly qualified GPs face a range of challenges as they transition into independent practitioners, a pivotal moment in their careers but also an incredibly daunting time. It can be a huge shift with suddenly shorter consultation times, a new administrative burden, learning to navigate primary care without the same supervision and support for the clinical and decision-making responsibilities they now bear. Uncertainty around career progression can add to the stress. It takes time to build confidence, and this can all make the early years of practice particularly demanding for new GPs, who may consider diversifying their careers at a much earlier stage.

The rise of portfolio careers

While the traditional partnership career path is well trodden and remains one that many GPs continue to follow, there is also a shift towards diversified, portfolio careers alongside (or, instead of) the traditional GP role. Whether for variety, improvements in work-life balance or to pursue a special interest alongside generalist work, many GPs are and have considered being a portfolio GP, which offers an excellent way to continue working, maintaining their wellbeing and providing good safe patient care.

Portfolio careers can take many forms – which may include a combination of ‘traditional’ clinical sessions alongside work in any variety of settings. Many doctors find benefits in branching out, including exposure to a wide variety of industries, opportunities to contribute to improving patient care, and improving services and quality, which keeps the work intellectually stimulating and increases diversity.

This variety is essential for some GPs to continue practising, while also helping to reduce the risk of burnout by shifting focus between the different challenges that general practice has to offer. Portfolio work allows the individual to look at what they enjoy most about general practice and incorporate this into their work pattern, which enhances professional development and improves job satisfaction. The role offers variety, flexibility and most of all choice for GPs, which at different points of your career may be exactly what you need to keep working.

The world really is your oyster, whether you enjoy appraising other GPs, training medical students, supervising GP trainees, doing medico-legal work, providing private clinics in an area of your competency, skills and training, humanitarian work, aesthetics, working in a school, writing health articles or working within an ICB to improve services.

When considering a portfolio career, it is important to think carefully about what you are looking for and what sparks your interest, and if it will give you the balance you are seeking between general practice and other roles and responsibilities.

Support available

These can be exciting and ambitious transitions for GPs, that can bring many advantages for those looking for variety, a change of pace or to pursue specialist interests alongside generalist work, and GPs need the reassurance and support of their defence organisation, in a way that fits the way you work. We speak to many GPs and recognise the difficulties that GPs in a careers crossroads can face when under pressure – whether in a new role, a new location or just still finding their feet as they transition into their new careers.

GPs at all levels – but especially those who are considering their next stages – need reassurance and guidance from a team who recognise the challenges you face, the risks this brings and ways you can mitigate these. Alongside our expert legal advice, the MDDUS offers support, encouragement, and kindness; no one wants to have to contact their defence organisation, but we are here for you when you need us.

The benefits of your membership with us also includes access to education, guidance from peers and wellbeing support, as well as providing tools, training and content that helps GPs reduce risk, stay up to date and avoid common pitfalls – to help our doctors manage risk, make confident decisions and build lasting patient trust, and helps them feel more confident and supported as they grow into new roles.

And if you do find yourself subject to complaint, inquest about patient care, disciplinary or GMC investigation relating to your clinical practice, we provide you with the support, advice and guidance that your need. We can provide expert medico-legal advice for situations that you may face, with our telephone advisory service available 24 hours a day, seven days a week.

Cover for routine non-NHS and fee-paying activities undertaken during NHS patient care is already included as standard with MDDUS membership.  But if you are diversifying your work or income – such as focusing on a special interest or taking on private consultations – then do reach out to our membership team to ensure that you will have the indemnity support and cover that you need. Our supplemental cover options to your membership can be tailored to fit, and the MDDUS membership team would be happy to discuss your specific roles and requirements.

Dr Natasha Castellino qualified as a GP in 2019, and completed a postgraduate certificate in medical law, before joining the MDDUS in 2022. Dr Roopinder Brar completed a masters in medical law and ethics and continues to work in general practice, alongside her work at the MDDUS.