- Posted Tuesday June 18, 2013
Having worked in my present surgery for 8 over years as Practice Manager I have just become a Managing Partner as of April 1st 2013. In this article I hope to put over how and why we reached this decision and the things to consider if you are asked to become a partner.
Why should you become a managing partner?
It is now becoming more popular for managers to be partners.
There are many reasons for this development. Doctors came into the profession to look after their patients and not to handle the increasing paperwork, nor to manage the constant changes that successive governments seem to impose.
That is why most practices have either practice or business managers. To cope with the day to day running of the surgery, including staffing, reporting, financial planning and keeping abreast of the ever changing face of the NHS. We handle all CQC, QOF reporting and ensure that patients get the best attention at all times.
So one could say that the role of a manager has become more important to a surgery. By offering partnerships to managers it can ensure that managers feel personally involved and that they are less likely to move positions as they have taken ownership for their work and rewarded accordingly.
How it all started...
Up until May 2012 my surgery had been a 2 partnered practice but the partnership broke up for reasons that are not relevant to this article, although, it did lead us to take this decision for me to become a Managing Partner.
Over the years the main partner and I have forged an excellent working relationship built on communication and trust. I am left to manage and the doctor sees patients.
Obviously, the period after the break-up was difficult, with us having to ensure the smooth running of the practice with the minimum fall out by the dissolution. I cannot say it was easy but we did manage to work through the problems and I think the staff that were unsettled could see the main partner and I were trying hard to steady the ship.
In discussions with the accountants and the remaining partner during the months that followed, we looked at the future of the practice and discussed various scenarios.
It was clear that we could remain as we were, but it posed a risk to the viability long term, so it was recognised that some action would need to be taken to lower this risk and hopefully lead to some succession planning. We also saw the threat of private firms coming in and felt by taking this action it would mean the surgery was more secure.
One of the options that could be taken, was briefly touched on, was for me to become a partner. Whilst, of course, I was flattered I needed to do some research and decide if this was right for me and, of course, the practice.
Where do you start in becoming a managing partner?
I researched what it would involve using the internet and of course the First Practice Management website, as well as getting accountancy and legal advice.
My original findings like most things were confusing. If I decided to go ahead I would become self-employed and loose some employment rights. I would also be responsible for paying my own tax and national insurance so would need accountancy input.
Then I had to look in to whether to go for equity, a fixed share, a percentage share, profit or non-profit sharing partnership to mention just a few. So it was clear that careful consideration had to be given to all the options and this was something both sides should not rush into.
Things went quiet for a little while, I think we were both considering the next move but in November 2012 the subject of me becoming a partner was once again raised by the remaining partner. So we had another round of discussions but this time more in-depth as we both had more knowledge and could discuss the topic more fully.
Of course the issue of whether the PCT would be in favour and support such a move would have to be sought before really moving. We were not sure of their reaction to such a request.
We were not really aware of any other non-clinical partners in the area. (It turns out there are actually a few in the area) So we decided to arrange an exploratory meeting in early January 2013 with the Contracts Department of the PCT to gauge their position on such a move by us.
They were very positive and could see no reason as to why this would not be approved and felt it was a good move for the stability and the future of the practice.
After this we had a further meeting with our accountants who also were very positive on the idea. I had worked closely with them for several years so they knew our dynamics and realised this could work well for us.
They were keen for us to proceed and whilst they had other surgeries that had gone down this route, ours would be one of the smaller practices.
They were very fair in their advice warning of the pitfalls but also of the advantages to both sides. We then asked them to put together figures for remuneration etc.
In the meantime we contacted our solicitors who were not as enthusiastic as we were. No bad thing as it focused the mind on the real issues of what if?
During the next few weeks the existing partner and I spoke regularly and discussed the events as they were unfolding. With the demise of the PCT on March 31st 2013 we felt that if we were going to proceed we would need to move sooner rather than later whilst we had positive support from the then PCT.
The partner and I had also discussed plans for the future development of the practice and also how we see the next few years ahead realising we cannot keep still.
It was quite clear that we were both of a similar mind and that the more we spoke the more I felt it was a right decision for me. The existing partner was concerned that I was happy to proceed and that he was being fair and that I knew any potential risks.
We mutually agreed that if we did go ahead I would be a fixed sum partner so that I was guaranteed a set figure. I have to say initially the figures worked out by the accountants were less than fair but after some tooing and frowing we agreed between us on the final figures.
A further brief period for thought and reflection and then we agreed that this was going to be right for both of us and so the first week in March 2013 we notified the PCT of our decision to proceed. They confirmed their agreement and asked for us to agree to this as from April 1st 2013.
At the same time we broke the news to the staff and also the former partner. The news was met very positively and indeed despite the situation is working well.
We then proceeded to get a formal contract drawn up through our solicitors. This probably caused the most work and attention as they base things on, one hat fits all, when really such contracts need to be bespoke. After a couple of drafts we have finally signed up and the future beckons with optimism. We have already started on implementing our business plan.
So what advice can I give? Obviously no two practices are the same and obviously any decision can go wrong and there are always risks. In my case the risk of doing nothing was also there as we discussed this in future possibilities.
In brief I reached my decision based on:-
- Lots of discussions and research along with taking it slowly in the thought process.
- Getting professional advice from solicitors and accountants and ensuring that this advice was clear and concise.
- The existing working relationship I had with my now partner which was extremely good with mutual trust and openness.
What are the negatives in becoming a managing partner?
Obviously I have given up my employment rights as I have to be self-employed but I feel it is a small price to pay and works as an incentive.
I thought that it would be a challenge, and yet give me some security.
However, warnings must be to ensure that you are comfortable with the change, that the terms are fair and clearly set out in a Contract and that you are able to handle the increased responsibility.
It is clearly not right for everybody and my advice would be to seek out as much advice from as many sources as possible and then make an informed decision.
What is the main factor to consider when becoming a managing partner?
I would say that the main factor is to ensure that you are going to be able to work with the existing partner/s and that all sides are aware of the changes in a relationship this can bring.
In my case I am about 10 weeks in and I can say I do feel different even though my work has not really changed I have a much more feeling of ownership than before.