The Portfolio GP – Dr Hadley Skidmore

This week brings the final blog in our portfolio GP series, we hope you’ve enjoyed hearing from our GPs and if you’re thinking of pursuing a portfolio career are feeling inspired.

Now read on to find out how Dr Hadley Skidmore created a portfolio that he loves.

What does ‘portfolio GP’ mean to you?

I am a portfolio GP, that’s the first thing to say. To me, it means that I have a number of roles that form my work. The beauty of that is that I can scale up or scale down in one or a number of roles that I do.

How do you divide your time? My different roles involve a number of things which include working in the NHS doing GP surgeries, doing private visiting work through GPDQ, working for the General Medical Council assessing other doctors, other MedTech related work, some publishing work, and some medico-legal work. I also do voluntary work with some people living in Zambia, where I am a doctor for them remotely giving medical input, and the work is relayed to me by the internet.

What made you go down the portfolio route?

When I was a trainee, there were lots of people that wanted to be a partner at a GP practice. For me, that was never a given. I thought, ‘well let’s give this a go’, but I am quite flexible with the way I work. The environment in GP was quite hostile, people were leaving and the government wanted us to do more for less. It was an absolute recipe for burnout. I myself didn’t exactly experience burnout, but I recognised when it was getting too much. Something needed to change and I needed more of a work/life balance, so that’s what prompted me.

Does a portfolio career support a good work-life balance?

Yes. The benefit is that it is quite fluid. It does bring variety to the work. I will never ‘not do’ NHS work, but the nature of doing NHS work is that it often feels like a factory production line. It’s quite full-on and there is only so much of it that you can do before you burnout. Therefore, you have to look towards doing a variety of things to actually feel revitalised; that essentially is the key for me.

Do you think having a diverse portfolio makes you a better doctor? And how does it affect the patient care you deliver?

I do. It means that when I do one type of work, I am not stale because I am doing other types of work. When I do a particular type of work, I feel fresher. It also gives me a varied skillset. For instance, doing voluntary work gives me a tropical medicine spin to what I do. Previously, I used to work in evacuation medicine and it was so varied. It involved treating people all around the world, whether it was oil rigs, or vessels in mid-Atlantic or sub Saharan Africa. It gave me an experience in treating people in tropical medicine. It also involved roles in occupational medicine and aviation medicine, so these are all different types of medicine that has given me my skillset and experience. Subsequently, I have been able to deal with tropical medicine more easily, especially since my work involves seeing tourists. You find yourself doing a particular area of medicine, but it does lend itself to other areas. It becomes a symbiotic relationship between all the different roles that I do.

Do you see portfolio careers as the future for general practice?

I think portfolio would ultimately help with the recruitment situation. They need to get more doctors into general practice and I think portfolio GPs would help, but it is not the only thing. I think the way to attract more GPs to general practice is to get rid of all the bureaucracy and micromanagement. Essentially, allowing doctors more time with their patients, because people are complex. People are far more complex than they used to be and we have to do a lot more than we used to with less time.

Do you think the health sector supports portfolio careers?

I think it does increasingly. I think they have taken on board the fact that portfolio GPs are kind of what people are doing now and this is what interests them. I think Bristol, Swindon, and various places in the country have been advertising portfolio careers. I don’t think they’re making it difficult, there are definitely opportunities and schemes out there.

What message or advice would you give other doctors about the portfolio route?

I think you have to find your own journey. There are lots of options out there. I would say that general practice is an amazing platform for doing lots of other things. The trouble is that a lot of people are trained in the NHS and they have a certain tunnel vision about options that are available to them. But GP opportunities are endless, which people in the NHS don’t always realise. I would say research well, find people who do what you want to do, make contact with them, and find out how they got into what they do. General practice is a key to many doors.

If you could send a message to the NHS about portfolio GPs, what would it be?

I think by accommodating the role of a portfolio general practitioner the NHS would actually enhance a long-term profession in the UK’s health system. I have friends who have moved abroad to Canada or Australia, or left medicine completely. Even if it means that someone is doing one day a week in general practice while doing other things – medical or non-medical – who cares?! They are still contributing in one way or another.

GPDQ is the UK’s first on-demand app for private GP visits.

See a trusted, local doctor at your home, office or hotel within an average of 90 minutes in London. Available 8am – 11pm every day. Find out more

The Portfolio GP – Dr Kieran Sneath

This week we hear from Dr Kieran Sneath, a GP that loves the variety his portfolio career brings.

What does ‘portfolio GP’ mean to you?

I am just a GP that likes to keep a varied interest and do different things. I guess by convention, anyone who works outside the normal scheme of either being a partner or salaried GP is by nature a ‘portfolio GP’.

How do you divide your time?

In terms of my working week, I work as a freelance sessional GP in regular practices in North London and Hertfordshire. This includes your conventional family medical practice but also in a university medical centre as well, which is very interesting being involved in primary care of healthcare needs of university students.

On top of that, I work as a private GP doing home visits for GPDQ, I am a specialist advisor for the CQC doing inspections on healthcare organisations, and I do some work doing private medicals, for example, occupational health medicals for patients who want to become drivers or taxi drivers.

I also have an evolving interest in digital innovation within healthcare, which I am currently thinking about and have inroads and avenues I am pursuing. I have interests within GP as well, in particular musculoskeletal and sports medicine.

What made you go down the portfolio route?

I think for me it was quite serendipitous. I didn’t necessarily set out this way. I like variety in my work. I like to be in more control of my schedule and do different things. I also don’t like to be stuck in one particular place all the time. I suppose it was just by experience, opportunities, coincidence, network, and connecting with different people. Opportunities come up and I thought, I would like to do that. After a while, it moulds into a cohesive work plan and if you get it right, you can set it up so that you are doing regular work, but with variety.

Does a portfolio career support a good work-life balance?

Yes, I have a good work-life balance. I am able to do the school run in the morning. I am able to go home for lunch most days. I may want to take time off if I need to have an appointment or if it’s my children’s sports day. There are other people I know that just can’t do that. Obviously, a lot of my work is self-employed, but I think, as long as you manage your work and life appropriately and you budget for those times, it really works well. I don’t think I have ever had a better work-life balance.

Do you think having a diverse portfolio makes you a better doctor? And how does it affect the patient care you deliver?

Yes, for me definitely. I think firstly, variety is very important. I don’t think you gain experience by just seeing more patients. It is also about seeing different patients in different environments. For example, when I do a CQC visit, I can see that some things are done really well and I can take it back into my own practise.

Do you see portfolio careers as the future for general practice?

I wouldn’t want to state unequivocally that it is the future for all GPs. But I would certainly say that it would benefit a lot of GPs. Newly qualified GPs should not be scared to step outside of the conventional box and do other things as well. The traditional route of becoming a GP followed by doing a salaried role or partnership; those days are in decline. I do know GPs that are newly qualified and have gone straight into a partnership. They are very happy and I think that is for them. But I think for a lot of GPs now, they should consider other avenues as well, to complement the traditional approach.

What message or advice would you give other doctors about the portfolio route?

I think by adding different themes into one’s work, there is less chance of burning out, so that you are actually more refreshed. NHS clinics are really rewarding, and I really enjoy it. But they are quite intense and it requires a lot of concentration. If you are doing that all the time, it can really wear you down. But if you are doing something else, you are going to be a bit more refreshed. I think it refreshes and invigorates you and prevents burnout.

I think I have probably come close to it (burnout) at points, but I recognised when that was happening and took action to do different things. I think the danger is when people aren’t able recognise that they are burning out and just keep heading down. So many more mature GPs are retiring early and so many younger GPs are going abroad. The portfolio career may not be for everyone, but I certainly think that it will sustain a workforce to work harder, over a longer period, and ultimately be happier within the NHS as a result of doing other things as well.

If you could send a message to the NHS about portfolio GPs, what would it be?

With such recruitment and retention crises going on in the NHS, it’s crucial to make the NHS work more feasibly and be more attractive to people. I think that the NHS needs to realise GPs want to work flexibly. In order to prevent burnout and sustain a workforce in a really difficult and challenging environment, we need to be open about GPs being able to work outside the NHS, to keep them refreshed in both the health of the doctor and the benefit of the patients that they see as well.

 

Tune in next week to hear from Dr Hadley Skidmore.

GPDQ is the UK’s first on-demand app for private GP visits.

See a trusted, local doctor at your home, office or hotel within an average of 90 minutes in London. Available 8am – 11pm every day. Find out more

The Portfolio GP – Dr Zuhaib Keekeebhai

This week we interviewed Dr Zuhaib Keekeebhai, he believes that keeping your options open can lead to a fulfilling career and work-life balance.

 

What does ‘portfolio GP’ mean to you?

Being a portfolio GP gives you the opportunities to do whatever you want. And month by month, these opportunities increase.

 

How do you divide your time?

Life is pretty hectic. It’s always interesting because you don’t always know what’s happening the next day. I am a part-time GP, I do three clinical sessions and some out-of-hours (extra evenings or weekends).

I do one session in management, where I manage a practice. One of my interests is practice management and IT setup, optimising services (eg. local commissioning incentives) and making it as efficient as possible by using IT.

Then I do three sessions working for the Islington GP Federation, where I am responsible for helping a QIST program. In this role, I build up templates, work out ways of making things more efficient using IT, and visit practices to listen to their problems as well as solve them.

I am one of the clinical leads for a CCG, working on safe and effective pathways for intermediate care, which is the midpoint between secondary and GP.

I also sit on the Whittington Hospital quality board, where I find out what they are doing and assess their quality. Finally, I am on the individual funding request (IFR) board.

I admit, it sounds like lots of things going on! A lot of it is dynamic, decision-making and coordinating how things are done. On top of this, I also do GPDQ shifts.

 

What made you go down the portfolio route?

It just happened. I was a ten session GP, then I dropped to six and out of hours. I had this dilemma of how to have a good work-life balance, where I still want to work, but not burnout. I looked out for advertisements for CCG events. I used to go to all these events to network, and meeting people just brings up opportunities.

 

Does a portfolio career support a good work-life balance?

Very early on, I recognised that I couldn’t see patients for more than four days a week as a GP. I would get very moody, and seeing potentially 40 patients a day – every single day – takes its toll. I find it very useful to add different elements and spice to your life and to your work-life pattern. It makes things interesting, less boring, and less intense. Although my schedule sounds really busy, I would struggle if I said, “Monday to Friday I see patients”. I think it is important that GPs do lots of different things.

 

Do you think having a diverse portfolio makes you a better doctor? And how does it affect the patient care you deliver?

I think so, because by spreading my patient contact, I feel fresher to see them and more energetic. On Monday you are the best GP, but by Thursday or Friday, you are pretty fatigued. I don’t think that’s a good picture. Whereas, you pick up things when you do different work; a different understanding of good practices and/or what works best for patients and general practice. I think if you stay in one GP practice day in and day out, there is less opportunity for development and learning.

 

Do you see portfolio careers as the future for general practice?

Yes, definitely. I think the ambition is that we are all going to work selectively at scale and eventually there will be offers to retain GPs. For example, the environment will be easier, seeing patients in 15 mins versus 10 mins, admin done by someone else, and leadership opportunities. I think that’s going to be the future.

 

Do you think the health sector supports portfolio careers?

I think so. I think there are new GP retention schemes out there, where practices are partnered up with CCGs to promote certain positions where you can practise for four sessions a week and do two sessions a week doing something else.

 

What message or advice would you give other doctors about the portfolio route?

Do not commit to one surgery. Keep your options open. That’s my advice.

 

If you could send a message to the NHS about portfolio GPs, what would it be?

The reason why GPs are leaving is because it’s not sustainable to see patients more than four times a day. There is all this burnout and depression. I think if people had these other opportunities and support to look into doing other things, they would be less likely to leave to other countries. I don’t think the NHS gives doctors enough incentives to stay. I would say, the sector should consider how to make it easier to become a portfolio GP, because we’re more likely to retain GPs and to have well-rounded GPs who better understand the NHS and population health. It might help with taking work out of secondary care, making GPs experts in cardiology, dermatology, rheumatology and so on.

 

Tune in next week to hear from Dr Kieran Sneath.

GPDQ is the UK’s first on-demand app for private GP visits.

See a trusted, local doctor at your home, office or hotel within an average of 90 minutes in London. Available 8am – 11pm every day. Find out more