Dr Fiona Cornish: Have a frank discussion
An excellent trainee is such an asset to a practice and after all the work put into training, it is disappointing if your young doctor decides she is not keen to stay on.
If your trainee says she doesn’t want to stay, the first thing to do is to find out why. She may have committed to move to another area, for example if her husband or partner works elsewhere.
But if she would consider staying with you, make sure she is fully informed about the financial implications and responsibilities of being a partner. For example, she may think she would be obliged to buy into the building, which can be an intimidating prospect. Once you have explained that there are advantageous loan arrangements available to partners, she may feel more confident about the prospect. Advise her that if finance is an issue, she could settle in for a couple of years before buying in – most practices offer this arrangement.
Becoming a partner is not necessarily a fixed commitment as the number of sessions can be adapted to circumstances – for example, if she has young children and wishes to work less. The partnership might agree that the new partner can negotiate the number of sessions and on-call commitments. Be aware that your candidate may also want to discuss details set out in the partnership agreement, such as maternity leave.
Dr Fiona Cornish is a GP in Cambridge and a former president of the Medical Women’s Federation
Dr Helen Stokes-Lampard: Talk up the relationship element of partnership
In the current climate, brilliant trainees are worth their weight in QOF points if you can retain them.
First, I would check that all your partners feel as you do and that her trainer has not already had the conversation (which they really should have done).
Second, since there is no point wasting your time or hers if she wants to move to the other side of the country for personal reasons, I’d be looking to have an informal chat over a cuppa about her plans. If she gives any indication of wanting to remain in the area, grab the opportunity or suggest a more formal chat in private.
Third, have an honest, positive conversation about how much the partnership respects her, how proud you are of the fantastic GP she has become during her time with the practice and how well she fits with your team and ethos. Then invite her to give you her own feedback.
If she reflects positively, tell her that you had really hoped she might consider becoming a permanent member of the team to help shape the future for the practice and patients.
Highlighting the positive aspects of joining would need to be tempered with honesty about the realities of being a partner in the UK, of course, but emphasise the relationship element of partnership, and the benefits of being able to trust and work with colleagues long term. That should do the trick.
Dr Helen Stokes-Lampard is a GP in Lichfield, Staffordshire, and honorary treasurer of the RCGP
Luke Bennett: Don’t overburden the candidate
Once you know whether the candidate is expected simply to join, or to replace
a retiring partner, you can check with existing partners whether they’d accept a dilution in their profit shares if she were to join. If she is to replace a retiring partner, anticipate what skill overlaps or gaps this will create. Review why you want your newly qualified GP to be a partner, and whether she shows the required interest and aptitude.
Partners need to think beyond the clinical issues she would have been exposed to as a trainee and about the wider challenges of running a business, such as skills and experience in finance, HR, developing new services or administration.
As a newly qualified GP, she will make her decision about partnership largely based on what she has seen of the current partners’ job satisfaction, cohesiveness as a group and work-life balance.
Finally, and these are not necessarily as important as the non-financial aspects, line up other benefits to make a partnership attractive, such as holiday entitlement or maternity leave provisions, if poor profitability makes it difficult for partners to earn more than salaried GPs.
A new partner is likely to have to introduce some capital, but this should be structured to make it as painless as possible for the new partner, for example, by allowing capital to be built up over a number of years, or helping the partner arrange a loan – perhaps through the existing relationship the practice has with its bank. Factor in the loan repayments in comparing likely profit levels and drawings with the take-home pay she would get as a salaried GP.
Luke Bennett is a partner at Francis Clark LLP and a member of the Association of Independent Specialist Medical Accountants