At 28 I’d just finished GP training and was starting out. What do I know now that I didn’t then? What advice would help? Some of this is personal – I have learned my particular faults – but much of it is applicable to others and, I hope, helpful.
Learn your craft.
You know lots of medicine and have lots of experience, but you are only just starting to build relationships with patients and look after them. There is no substitute for hours spent consulting. Admit your faults, learn, improvise, practice, ask for help and don’t be too hard on yourself. There are lots of resources to learn clinical skills so embrace those that work for you. Seek the advice of a mentor.
Try different things.
General Practice offers a huge variety of side hustles, so experiment widely and see what you like. Do some out of hours to get experience in looking after acutely sick patients. Medicine can open doors to sport, expeditions, working abroad (etc.) but you also need your core GP career to pay the bills.
Embrace practice management.
It can be tempting to think that running the practice is not your job and leave it to others. But the strength of General Practice is that the business is run by and for the partners – this reduces management costs and makes it financially viable. Get to know how the practice works. Where the money comes from. What it is spent on. How people are hired and fired.
Study Leadership.
Teams need to be well led to thrive and as a doctor and partner you will naturally tend to be in a role where you are expected to lead others. However, that doesn’t mean you will be any good at it. Leadership is a learnable skill so read about it, talk to others about it, practice it. And looking after patients effectively relies on a well functioning team every bit as much as your clinical skills.
Prioritise relationships.
Perhaps my most enduring regret is that I haven’t made time over the years to keep up with old friends. The work seemed to get in the way, and we drifted apart. Get organised. Make time to see people you care about and plan. You don’t keep strong ties by accident. This is still a work in progress and even now I need to focus to maintain friendships.
Read widely.
You don’t know how what you don’t know will help you. There is no substitute for gaining knowledge and perspectives outside your field. With so much medicine to learn this can seem a luxury, but you will reap enormous benefits.
My current favourites:
The Right kind of Wrong – Amy Edmondson
The Culture Code – Dan Coyle
The Infinite Game – Simon Sinek
Think Again – Adam Grant
Supercommunicators – Charles Duhigg
The Hard Thing about Hard Things – Ben Horowitz
The Lean Startup – Eric Ries
You can have an enjoyable and fulfilling career as a GP.
When I started, I was repeatedly told by older GPs that General Practice was doomed and the changes of the “new” 1990 contract would be the end of it. The current crisis, with over 99% of the GP vote rejecting the government imposed “pay deal”, seems similarly bleak. But it turned out that locally run GP partnerships who know their patients and enjoy their jobs have remained the most cost-effective way to look after patients.
If GP partnerships remain the best way of caring for patients, then it doesn’t seem smart to bet against them.