Joel Brown is a family physician.
As a salaried GP, I don’t have to think much about human resource or financial management, and I can pretty much just do the job of clinical management for the patients I see. However, more often than not, GPs are working in other ways, such as locum contracts, healthcare consultants in the private or public sector, GP partners, or as portfolio GPs who are taking on leadership or management roles in professional collaboratives and cooperations.
GPs who are trained to understand the anatomy and pathophysiology of their patients’ problems are increasingly required to understand the anatomy and pathophysiology of the organisations they are employed within, own, or partner with.
When we mitigate one patient’s problems, we satisfy one person, when we identify and mitigate the problems in a healthcare organisation effectively, we satisfy thousands of patients, employers, and employees.
It really is tragic that our profession still hasn’t caught on to the revelation of how illiterate GPs are about the business mechanics of their industry.
Long gone are the days when we could just consider ourselves exclusively clinicians, indifferent to the inner workings of healthcare organisations, wider industry, and its regulatory bodies that make our work feasible.
I can remember talking to a friend and colleague of mine who became a GP partner 18 months after concluding his GP vocational training scheme. We had just finished our vegetarian full English at a street-side cafe in the historic town of Saltaire, and he remarked about how he had grown from strength to strength and gained confidence as a clinician since completing his GP training.
His smile quickly crumbled into several furrows, sucking the air out of the room as he described how painfully unprepared and thoroughly incompetent he felt at understanding the business of general practice, employing and managing staff, nor managing his taxes and pensions as a self-employed contractor.
He could think of nothing that prepared him for this and was considering paying out of pocket for several crash courses to get him up to speed with it all so he wouldn’t make a dramatic financial failure of the entire opportunity.
Primary care clinicians need to be confident business and healthcare management leaders soon after qualification.
It really is tragic that our profession still hasn’t caught on to the revelation of how illiterate GPs are about the business mechanics of their industry. The level of training doesn’t need to be at the MBA level, but I think we should be able to earn a Postgraduate Certificate in Primary Care Business, Management, and Leadership as part of our vocational training, which in the least helps prepare every GP trainee to navigate the corporate matrix in which we work and provide care for our patients.
It would also facilitate our understanding of the priorities of clinical leadership and equip those who want to pursue roles such as medical directorship or clinical entrepreneurship. Failing to provide this education as mandatory in our training is a failure to face the professional demands of our time, and neglects a crucial opportunity.
Primary care clinicians need to be confident business and healthcare management leaders soon after qualification. This may well fall on deaf ears for some, but it’s about time this becomes an educational priority to those with the power to shape the educational future of general practice.
Featured photo by Visual Stories || Micheile on Unsplash.
Dear Dr Brown,
I could not agree more. GPs working in Japan are in a similar situation. Thus, I entered an MPH course in Healthcare Administration and Management before being a GP practice director. However, careers such as mine are relatively uncommon in Japan. Having said that, going into management unprepared is like going into battle unarmed. Thus, the GP vocational training should contain a minimum of management training.
Best wishes,
Koki Kato
Great article but I feel the “long gone days of GPs being considered exclusively as clinicians” are the days that need to come back. Too many GP hours are spent in meeting rooms and care provision planning, all of which take time away from the actual provision of care. We primarily trained to be clinicians but that’s the one thing many GPs don’t do anymore as they chase a portfolio career. GP numbers are already dwindling but I suspect the percentage of GPs who work exclusively as clinicians is dwindling faster
I agree that GPs should learn more about business and management during their ST years. Far more is being asked of them in these areas as well as being asked to work as Public Health doctors- assessing population needs and strategically planning services.
I can’t agree with the comment that GPs have historically only been clinicians. Being a small business owner operator is central to Partnership. We need more emphasis on what that means and how to use it because it’s central to our flexibility.