GP Partnership has become a less popular option for GPs in recent years. Since 2015 the number of full time equivalent GP Partners has dropped 21.6% according to NHS figures. But the right GP partnership can make a lot of sense by providing a professionally rewarding and profitable career choice. Here Dr Tommy Perkins, GP Partner and co-founder of Medics’ Money, tells us what GPs should consider when looking for a good GP Partnership. Medics’ Money empowers doctors to make better financial decisions and you can find details of a new course to support GP Partners here.
Finding the right partnershipEach of us has different priorities in what we want from a GP partnership and it should not just be about the financial benefits. For example, cycling to work is important to me to maintain my physical and mental health so I only considered partnerships that I can cycle to. But each of us is different and the right cultural fit for me may be very different from you. That’s why either prior experience of working at the practice or a mutual assessment period prior to joining the partnership is vital. Whilst our preferences for cultural fit may be different, joining a partnership is a big financial commitment and the financial health of a GP Partnership should be a major determinant in deciding whether to join a partnership, irrespective of whether you can cycle there.
How can I tell if a practice is high earning?If you are thinking of joining a partnership it is vital to get a copy of the recent accounts. The accounts are the vital signs of the financial health of the practice. You are expert in analysing your patient’s vital signs like blood pressure and blood tests to reach a diagnosis. But it’s likely that GP training taught you absolutely nothing about analysing the vital signs of a GP business and diagnosing if the business is well or unwell. Whilst I would always recommend going over the accounts with an experienced medical accountant, there are some red flags warning signs that you can look for yourself.
Red flags in the accounts
Brackets – mean a negative numberBrackets on a set of accounts are used to denote a negative number. Not always a problem – but if the bottom line has brackets, that is an issue. So if you see brackets, have a closer look.
A list of partnersThe list of partners can be telling. For example, have there been recent changes? If so have these been a case of normal retirement or is it an indication of unhappiness within the practice? Try to find out more about the history of the practice and reasons for partnership changes. What other planned changes are there?
Accounts finalised lateIf the practice year end is March and it takes until the following January to finalise the accounts – why? Perhaps there is a problem with partners disagreeing with figures or a problem with timely supply of financial information. If the financial information is not being collected and flowing easily through the practice this may be a sign of trouble. Other resources to analyse the accounts include this article by my colleague Ed who is a GP and Chartered Accountant.
How to find a high earning practicePartly due to the way funding is allocated to GP practices, certain types of practices can earn more:
- Dispensing practices with a high list size and with a well-organised dispensary
- Practices with high disease prevalence and high levels of enhanced services
- Practices with a very high ratio of low paid salaried doctors to partners (although it is unlikely that such practices will offer any partnerships)
- Practices with very high levels of patients per doctor (but this is probably through need rather than choice and unlikely to be sustainable unless additional resources are brought in which will reduce profits per partner)
- Stable partnership (low turnover of partners)
- Partners work as team and trust each other, plan ahead and meet regularly
- Partners have similar philosophies in terms of the dichotomy between money and patient care
- Proactive rather than reactive teams
- Good managers of time
- Well-organised GPs with strong staff teams and good skills mix amongst them
- GPs who delegate well to paramedics, nurses, health visitors etc
- GPs who work long hours, have low deputising costs and a high level of non NHS earnings