As a GP, there are dozens of directions you can take your career. And when you’re just getting started, that can be an intimidating prospect.
As part of our 21st Century GP series for newly qualified and First 5 GPs, Lantum’s Portfolio GP webinar outlined how to kickstart life as a portfolio GP. Read on to hear what Dr Neil Modha, GP and chair of a GP Federation and Dr Ishani Patel, GP and clinical co-founder of Lantum, had to say about starting out on a portfolio GP career.
Staying within your threshold
“A lot of GPs, whether they’re early, middle or late career, will go through different energies depending on their personal lives and what’s going on,” said Dr Patel.
When you’re deciding what you want your career to look like, there are lots of different opportunities, from roles outside of medical work to the right number of clinical sessions to work each week.
Every GP has a different threshold for stress and burnout, but Dr Modha and Dr Patel agreed that six sessions is probably the maximum GPs should take on for full-time work. Any more than that and you risk your tap running empty – and patients will be able to tell.
“There’s no wrong or right,” said Dr Patel. “Don’t let anybody tell you that working one day a week isn’t enough – I absolutely disagree with that. You’ve got to do what fits right for you.”
Dr Modha agreed, comparing the life of a GP to a marathon, not a sprint.
Both Dr Modha and Dr Patel advocated for the Japanese concept of “ikigai,” or “the reason for which you wake up in the morning”. In order to build a steady, sustainable career, it’s important to wrap your work around your life and let it fluctuate as you learn and grow.
Finding your career path
As you decide what you want to pursue, take some time to consider what you want for your career – stability or flexibility?
What interests and excites you? If you don’t share what you want to do with colleagues, no one is going to just turn up and drop the perfect opportunity in your lap. Dr Patel recommended thinking of yourself as both a business and a brand, with a solid LinkedIn presence that plays to your strengths.
She also advised new GPs to develop their career and stay focused, instead of rushing towards the next goal. Getting certified is a huge achievement in itself, and you don’t want to force yourself into something that’s not right for you.
When he first started, Dr Modha’s mentor told him to explore one thing at a time, then move on. Now his typical week includes:
- Four or five clinical sessions
- A training session with a registrar
- Supervising a workforce of paramedics, looking for governance issues and giving feedback
- A variety of different meetings for his GP Federation and other management meetings
Financial compensation is also an important part of any career. When you’re starting out, both Dr Patel and Dr Modha recommend looking at the lifestyle you want to lead – holidays, mortgage payments, family commitments – and make a plan from there.
Career options as a Portfolio GP
As a GP, there are lots of clinical career possibilities, including:
- Sessional work, locum or salaried
- Partnership
- Fellowships
- OOH, 111, or Integrated Urgent Care
- PCN and hybrid roles
- Digital and eHubs
- Private sector
- Pivot paths to mentorship, medical and non-medical
Outside of clinical work, you can diversify your portfolio through other pursuits, including:
- Medical education and university teaching
- Medico-politico work
- Commissioning
- Academic research or education
- Healthtech
- Media
- Social work and community
- Aesthetics medicine
- Expedition medicine
- Journalism
- Quality improvement
Dr Modha found a career path in commissioning because he was interested and people around him encouraged him to take the opportunity. Now he has funding to go out into the community and talk about population health. “The most impact I have day-to-day is at practice,” said Dr. Modha. “It’s about getting as much of the NHS as possible to move decision-making close to people and patients.”
GPs can also get involved in long-term strategic planning that sets goals for the health system. Dr Modha finds that the most impact he’s able to have day-to-day is at a practice, where he can advocate to move decision-making as close to patients as possible to account for different health inequalities.
Where to find new opportunities
Dr Modha and Dr Patel recommended a number of ways to find new portfolio GP opportunities, including:
- Local medical committees
- Digital projects
- Quality improvement
- Primary care network roles
- ICB opportunities or clinical lead roles through your local intranet or job board
- Fellowship opportunities at your training hub
- National publications
- Online community groups
Work smarter, not harder
No matter where your career takes you, it’s important to manage your time well and intentionally establish a good work-life balance.
Dr Patel’s favourite phrase is “hustle like an intern” – find short-term opportunities that feed into your long-term goals, and remember that money isn’t everything. Don’t be afraid to try something new, see what happens, and work from there.
They both recommended a number of ways to stay fresh and keep your skills sharp:
- Be organised
- Set boundaries around your time in different roles
- Be willing to share your learnings and ideas
- Embrace a mindset of continuous learning and growth
- Consider coaching or mentorship
- Be interested in lots of different things
- Practice regular digital detoxes and customise your “Do not disturb” settings
Free learning resources for GPs
Free learning resources are everywhere, and they’re more accessible than ever. Dr Patel and Dr Modha recommend:
- Ockham Healthcare, a podcast series by Ben Gowland that covers new ways of working in general practice.
- eGPlearning Podblast, a series from Dr Hussain Gandhi, a clinical director who breaks complex ideas about medical technology down to encourage discussion. (If you’d like to hear more from Dr Ghandi, check out the blog from our Digital GP webinar).
- The Business of Healthcare, a podcast where Tara Humphrey looks behind the scenes at the business side of healthcare by talking to NHS and private healthcare leaders.
- 2 GPs in a Pod, an older podcast filled with past episodes that deal with issues in primary care.
Keeping things in focus
Dr Modha and Dr Ishani’s final advice centred around keeping up the habit of doing face-to-face clinical sessions, even though there are so many opportunities for GPs. Without in-person work, it’s easy to de-skill and miss things over video that you might notice in person.
Throughout your career, understand the need for boundaries and balance, and change your approach to manag risk. Being a GP is about managing uncertainty, and purely remote work doesn’t help you build comfort with uncertainty because you’ll always be referring more complex cases to people that can see your patients in person, and you don’t get the rewarding end-to-end view of your patient’s treatment.
Both doctors recommended having one-, two-, and five-year plans to help you stay on track. As you work, keep track of your own levels of burnout and make adjustments if you’re taking on too much.
“There will always be challenges in general practice – we just need to be realistic,” said Dr Patel. “Our part of healthcare does 90% of clinical care for less than 10% of the entire budget. So there will always be challenges – but where there’s a problem, there will always be work to do to solve it and opportunities to learn and develop.”
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