Started in GP in 1983 when finding a practice was difficult - on 50%, 3
years to parity in nice area. Usual mixture of good and bad in most ways,
but there is no doubt in my mind that I, and most of my medical friends
worked harder and were more fraught by the end of three years than at the
beginning.
Went solo in 1988. Since then parity of work "offered" = parity of income,
partly because not high earning practice and that's what the market demanded.
No sale of goodwill because the government acquired (and I thought paid
compensation for) the goodwill of all NHS registered patients when the NHS
was founded. You can't sell something that someone else owns. Don't know
its ever been tested but perhaps you can sell goodwill of your non-NHS work
if you want to try.
I agree 50% is exploitation, but no normal recent trainee can possibly make
the same contribution on day 1 as they will on day 1000. It just takes
time to aquire the relationship with patients, the range of difficult
patients, and some admin. savvy.
As to SHO and registrar jobs being equivalent to working ones way up a
company, there may be some truth in this, but friends who have become
partners in large accountancy firms still had long periods as "senior
registrars". I'm not aware of anyone known to me outside of medicine
becoming a partner in a professional capacity on day one with an organisation.
The real problem is not how we treat incoming partners, its how we're
valued and paid overall. The early suffering shouldn't be any worse, but
it might actually be worth it if the job and the money at the end of three
years were "a little more attractive". Easing the early suffering means
b..... all if your career for life is no more than a recipe for depression,
anger, guilt and the rest.
Conclusion
Look for a place you'll be happy in. If young partners you better get on
with them and trust them. If old partners can you put up with them till
you're the boss? Money should never be more than one factor in the equation!
Julian Bradley
GP Tutor
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