£110,000 PA – “AM I BOVVERED?”

Published: 13th November 2007

Money, money, money, does it make the world go around? Can money buy you love? Or, are you "bovvered"? The conventional answers to the first two questions might be 'yes' and 'no' respectively depending how you interpret the songs written on these topics. However your own answer to the final question is both important - as well as revealing!

Last month it was reported that the average family doctor pay in the UK rose by 10 per cent to £110,000 in 12 months. Publication of this type of information inevitably attracts interest. Those GPs earning in excess of the average may understandingly feel good about themselves - an entirely natural emotion for any one of us to enjoy when we are recognised as being 'above average'. But if £110,000 pa is 'average' then clearly there must be some GP's earning less than £110,000. How should they feel about being, apparently, 'below average'? Should they be 'bovvered'?

Unhesitatingly 'yes' is my answer to this question. And why?

Let's turn the clock back one generation, perhaps less. If sex was discovered in the 60s then around this time a meteorite struck and fatally damaged an already endangered species, the patient partner. That is the partner willing to wait patiently during his, or her, formative years in partnership on the understanding that senior years would bring unconditional respect from junior partners, a lessening in partnership burden and the top slice of profits. What those profits might be was, of course, always a closely guarded secret - perhaps only traded in the strictest of confidence between one senior partner to another 'old friend'.

This ethos was not of course unique to the medical profession but commonly encountered throughout most of the professions. So what happened? As for the dinosaurs, when the meteorite hit, the world changed, and in many ways. Quietly but persistently accountants began reminding professionals that their practices were businesses. Younger partners began to challenge the pace of their progress of reward and influence within the partnership. Access to information about earnings, profits and conditions became easier, indeed limitless with the availability of the World Wide Web. Moving "jobs" became not unusual.

Fast forward. There is little tolerance or indeed financial space for the senior partner of yesterday's generation. The accountants are right, the practice is a business. If the performance of the business is 'below average' how long will the partners, as a whole, tolerate this? Will the partners be willing, unconditionally to support a practice which is demonstrably 'below average'?

Unless GP practices are uniquely different to any other professional practice or indeed business, the answer to these questions is 'not long'! Whether we like it or not, in very many cases, what someone earns and the work conditions they enjoy are part of the fabric against which career success is judged by the individual and his or her peers. No matter how happy you may believe your particular 'partnership' may be if, truly, it is "underperforming", and in the words of my school report, if the partnership 'could do better', not being "bovvered" is likely to be a recipe for disaster.

Personal, business, and competitive pressures are likely to destabilise the partnership and probably sooner rather than later. The world has changed.....and it keeps on changing. The mobility of "professional labour" in this changing and smaller world is already an established feature. And is it in the interests of patients for the practice to be less than efficient and financially successful?

What should be done? Here are some thoughts:-

• Pay attention. Do not ignore stresses and strains within the partnership.
• Open forum. Initiate debate within the partnership about the business as a whole. Set aside time for this. Seven pm after a busy day when the partners are tired and fractious is not the time for a policy overview. Work towards devising a business plan going forward.
• Examine the quality of the existing executive practice management. Is it 'fit for purpose'? If not, what should be done, by whom and when? Do not put off difficult decisions ... because they are difficult!
• Financial management. Examine the detail. If the business performance is below average, talk to the partnership accountants. Once a year may not be sufficient. Be prepared to spend time, and yes, of course money, with the accountants. The investment may pay off handsomely.
• Partner performance. The partners are the engine room of the business. They are the force which drives it. Is there consensus of what is required of partner performance? Are there partners who, one way or another, are not performing to the generally accepted norm, whatever that might be - the arrogant partner, the unruly partner, the lazy partner, the risk prone partner? Managing partner performance in the very large professional partnerships is not easy. In the smaller ones, ten or under, where most GPs are found, it is infinitely more difficult. However, if this aspect is ignored, it is the good partner who walks and it is the underperforming partner who stays.
• Legal health check. Make some assessment of whether or not the nuts and bolts of legal practice life are securely in place. And if not, set a programme to tighten things up where required. A short discussion with the partnership solicitor may well identify where potential problems and pitfalls lie. If these are not addressed, they may frustrate other steps which the partners wish to make as part of the overall strategy to improve the operational efficiency of the business and hopefully its financial performance.
• Partnership ethos. Parallels with the sporting world demonstrate that the most successful teams work hard on developing "the team ethos". Believing in the team and striving for its success does work. Many businesses are increasingly recognising the force of this and investing in the concept.
• Partnership profile. In most communities GPs retain traditional standing and respect. This is not just a 'nice to have' badge, but important for the business. It will aid patient retention and the winning of new patients.

"I did not go into medicine for the money," I hear you say.

If you are in GP practice, the retort may be 'is it realistic to believe that you can take the money out of medicine'? Complacency kills by stealth.

And remember that question "Am I bovvered ? Beware, the wrong answer will inevitably carry a health warning!

Tel: 0161 214 0500

Web: http://www.maceandjones.co.uk/