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6 August 2019
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It can be difficult to know at what point to step down from a position that’s impacting too heavily on your home life, writes Dr Matt Orr
Nationally there is more focus on general practice; demand has never been so high or expectations so great. New contracting mechanisms not only provide some great opportunities but also require significant work from all staff groups, especially practice managers.
There have been many shifts in our health economy. We have to work outside our traditional boundaries. Perhaps this shift in working practices does not appeal to you, or you are among the many who are burned out and stressed. It’s a great time to look at for new opportunities for a better work/life balance.
One PM I worked with chose to step down into a new role as receptionist within her own practice and told me she’d since realised practice management had been a lonely role. Now she enjoys being part of a team, doing a job to the best of my ability, then signing off and going home.
Below are some options to consider if you too are wondering whether your role is still for you.
Move to a less stressful role in general practice
This is not for the faint hearted. One of the positives of being a PM is the autonomy you have; the way in which you can balance all those plates to ensure that you have a successful practice. My belief is that if you have these skills it is very hard to let go.
Stepping down within the same practice can lead to a different kind of stress and pressure. You might not like how a new manager is handling things. They might change processes that you have worked hard to implement over several years.
And it may not be easy to become one of the team instead of the manager. We all like to think of ourselves as part of the team but being a PM means making decisions that not everyone agrees with. So going from a manager to an admin role could be a huge challenge.
However, it does work for some people. A PM I recently spoke to summed up her reasons. She decided to stay within the same practice because it was comfortable and she knew how things worked.
She had been with all the staff in reception for between 10 and 24 years and they had come through a lot together. She has been careful to leave the new manager to steer the practice, only offering her opinion when asked.
Move to a different role in another surgery
This is definitely an option if you truly believe that you want to stay in general practice, not just because it is what you know, but because it is what you have a passion for. A new surgery could be a new start.
But think carefully about what it is you really need. There are far less demanding roles outside general practice that can sometimes pay more and be less stressful. Consider how you will feel being line managed by a PM, rather than having seniority and making decisions.
Work towards retirement and succession plan
If you feel you are nearing the end of your career and want to continue to provide some managerial support, why not suggest to partners that you begin planning for the future of the practice when you are gone? This option still gives you autonomy to run the practice whilst also mentoring a potential new manager to take the reins when you retire. They could focus on the wider agenda with PCNs, whilst gaining the knowledge and understanding running a successful practice. It can be very rewarding.
PMs have been undervalued and overlooked for many years. This has been fine for some, who have felt able have run their practices to the best of their ability, almost under the radar of national NHS reforms. This new wave of contracts needs a more strategic approach to delivery and this is where managers need to think about what it is they really want for themselves and their future. Only you can make the decision about how you want your future to look; it is time to take control.
Dr Matt Orr is a locum GP in central Lancashire. He was a full-time partner for 12 years before deciding to become a locum and pursue other interests. He set up a training business, Orr Medical Ltd, which focuses on the management side of general practice, helping practices all over the north west achieve their goals.