If you’ve never thought about this, or not thought about it recently, then maybe you should. A lot of our successes and problems come as a result of our own actions so how will we choose wisely if we have not thought about what we want?
These desires are intensely personal and yours will differ from mine. But if we talk about what we would like to see happen, we will probably find others who want what we want and that may open possibilities for working together.
I want my practice to be solvent (*)
This is a fairly basic desire. For practices, making a profit is like breathing. If you don’t do it then you die. Quickly. But it would be a pretty poor life if your only aspiration was to carry on breathing. But for many practices, their ambition stops there. Which is fine if you live for your house or your holidays or your retirement plans, but since I spend most waking hours at work, I want more than this.
I want to be listened to and have control over how I work
For me this means being a Partner. If you don’t own and run the business, then you don’t get a say unless the people who do own it allow you. Of course, there are many good employers (including my practice) which try to empower all the people who work for them to speak up and take charge of what they do, but the only way you can ensure this happens is by being an owner.
I want great partners
I know that I don’t have all the skills and all the answers so I want to be part of a team of people who look after each other and pool their talents to be better than they could be as individuals. I want to share responsibility with them. I want them to tell me when I’m wrong. I want them to care about my growth and development. And I want to do the same for them.
I want to do great medicine
The desire to excel and be our best is hard-wired into us. I want to improve and learn and develop. But it sometimes comes at the cost of going the extra mile for patients and that is where I need a solvent practice, control over my work and great partners to help me achieve. It is not about competing or showing off. Others are smarter or more skilful or more compassionate or more adaptable than me. But I want to be the best that I can be.
I want to improve the health of our community
For me, this is the ultimate aim. I want our practice to be embedded within our community and help the population a whole. There are lots of things beyond our control such as education, poverty, employment and housing. But there will be times when we can do something to really make a difference – like working together with our neighbouring practices to quickly set up local vaccination centres.
So what difference does all this make?
Knowing that I want to improve the health of our community changes how I think about developing our practice. The practice in effect takes the income available from looking after the community and has to work out how to recruit the best quality doctors and nurses to provide the care. The working lives and happiness of our clinicians becomes important. Which is why we all get a say in how we develop, and it is unlikely that we will choose 7-day 12-hour routine opening.
How do you avoid vomiting when people talk about Vision and Mission Statements?
There is so much noise in the NHS about Sustainability and Transformation and Vision and Forward Planning. But unless our vision is shared and based on what each of us wants for our lives and our careers then it is all meaningless chatter. We have had some success at our practice by thinking about what we really want and then choosing things which further our aims.
We can all choose an alternative future to the soulless homogenised monitored drudgery promoted by the GP Forward View. But first we must talk about our hopes and our desires, so we know what we want to build instead.
(*) Solvent in this context means earning enough to attract good people