For many years I had harboured the thought that I would retire at the age of 60. It had nothing to do with the ever-increasing demands of the NHS - we had been through enough of them through the 80s and 90s - but more that I had experienced two of my senior partners work into their mid or late sixties and then die soon after retirement. So I knew that I would be doing some part time work.
But the big mistake I made was to assume that my partners would be accommodating of my ageing needs. I was offered a part-time partnership with a large practice in a neighbouring town. At that stage I was already doing a minor surgery session for them, which I think helped them to get to know me better - I would recommend practices to offer retired GPs similar opportunities if they are looking to recruit an experienced new partner. Likewise, retired GPs looking for a partnership should suggest these opportunities if they aren’t offered to them.
I currently work four sessions a week on Thursdays and Fridays. I still run minor op clinics and these generate income for the practice in addition to being a useful resource for patients. (I have Specialist Interests in joint and soft tissue injections, minor operations and vasectomies). The rest of my week is taken up by spending time with my family, gardening and cycling, amongst other interests. I am enjoying life and feel that when I am at work I am not stressed and am able to give much more of me to my patients than I ever could when I was full-time.
When I retired I took my NHS pension and the tax-free lump sum. This year I should also start drawing my state pension. With the outlook on pensions getting worse by the day it was perhaps wise to retire when I did. The new changes to the NHS over the last three years or so have largely passed me by and I leave it to my younger colleagues to worry about them.
I cannot understand why many doctors in Britain are retiring early, citing revalidation as a factor. If you have been having annual appraisals, it should not be a problem - I prepared for my revalidation exactly as I had prepared in the past for appraisals and have just been revalidated. Nor is keeping up to date the problem it’s made out to be - there are plenty of online modules available.
Partnership is changing
General practice is much more diverse and challenging than when I first started in the late 1970s. I often mention to registrars that while they have a lot to learn from me in terms of my experience, I have in turn to learn a lot from them in terms of what the latest thinking is in a whole lot of areas. I have lots of examples where I have learnt something from patients or looked up something on the internet during a consultation.
One good example is post-polio syndrome, where in fact the patient had himself reached at this diagnosis with his own research, having been presented with leg pain and weakness to several doctors. Fulfilling patients’ unmet needs and my educational needs (PUNS and DENS) is often intertwined in a single consultation.
For years I have been an advocate of having partners rather than salaried doctors. Some doctors don’t want the commitment of a partnership but the vast majority of salaried doctors would love to be partners.
But keeping them salaried is a foolish economy. If they are partners they will have a commitment to the practice and its success. By contrast many salaried doctors are exploited and through low morale often end up doing the bare minimum required of them. Also with a continuing turnover of salaried doctors in some practices, continuity of care suffers. Patients often don’t know where they belong and end up being mismanaged.
When more of you are partners, the ever-increasing burden of the NHS is more equally shared. I would advise any colleague who wants to go part-time to consider staying on as a part-time partner. Becoming salaried after decades of being a partner can be demeaning and difficult to adjust to. I would advise GP partners that, if they are considering taking on new doctors, to consider partners rather than salaried. It makes not only economic sense but is also the right thing to do for your business model.
Dr Guru Singh is a GP in Loughborough
