Lorna's Blog

Survival Tips for Practices

2011-08-01T03:21:00.000-07:00

As a GP with her own list of locums which you can use for fr-ee, I thought I'd send this article in case it's of some use. Remember to post your locum vacancies (on Gladclinic.com and as always, it's a fre-ee locum finding service for you)

Tips on to how to survive in the current marketplace

There are many private companies keen to provide medical services and are seen as key competitors to traditional GP practices.

Times have changed...it will not be long before the healthcare marketplace will be highly competitive. It will all boil down to too few contracts being chased or sought by too many independent providers.

To survive this change in the marketplace, surgeries might think of strategizing to survive in these changing times.To survive in the current marketplace, surgeries might think of being innovative in delivering value for money.

They can do this by :
(a) Merging with other Local GP practices which share a common vision and ethos.

Merging with other GP practices to form a 'superpractice' offers patients more than continued traditional old fashioned General practice type medical services.

The potential negotiating powers that such an alliance created by 2 or 3 GP practices merging together can result in a greater chance in procuring contracts to provide health services within a region.

The skill mix generated by an alliance of this nature is a huge advantage because it also means that the Partners in the GP superpractices can undertake to run specialist clinics for patients; examples include skin clinics or musculoskeletal clinics at reduced costs (by circumventing the need to refer patients to secondary care).

The greater the diversity of offerings that a superpractice brings to the table the greater the potential of winning contracts.

(b) Forming partnerships with specialists in secondary care to create a 'GP and secondary care service clinic' all under one roof.

This is one means of surviving changes created when district general hospitals and certain units in tertiary centres close. The technicalities of these partnerships involve detailed market research including the demographics of the community, analysis of current and future needs of the community.

For example, in low socio-economic regions with a high density population of young families, partnerships with psychiatrics, and psychological allied services would thrive whilst partnerships created with plastic surgeons in these communities would probably not be a good idea.

On the other hand if the community is affluent with 'trendy types', then a GP practice offering added services like cosmetic surgery, healthy lifestyle clinics and wellness progams with dieticians, sports physicians under one roof are more likely to thrive.

(c) Forming partnerships with Private enterprise.

In creating partnerships with private enterprises it is important to conduct due diligence. Naturally, Private enterprises are driven by profit and rarely do they take a long term view.

This means that the services that are provided will be streamlined and certain services that do not bring revenue to a public/private partnership are often scaled down. This might mean that people who most need health care like the elderly and children would be affected as certain services do not bring much income to the practice for example home visits, baby checks and childhood immunisations.

Whilst these are subsidised by the government, there will be a greater focus on provision of services that bring in money. Don't forget the bottomline here is money.

Watch out that you do not rush out to form any deals without spending time and taking legal advice before entering into a contract with private organisations to form a merger.

There are many deals that sound so good to be true so trust your good instincts always. The strengths of any business partnership is based on partners sharing values and establishing clear goals and a vision.

It is also important to run due diligence on the potential partnering private firm. It is not only very important to make sure that key research is done on the potential partnering company's background, financial history, accounts, and management but also on the morals and ethics of those who actually work in and manage the private company.

There are many private companies keen to provide medical services and are seen as key competitors to traditional GP practices.

To create effective partnerships with private enterprise, it is important to evaluate how the potential private firm can leverage the GP practice's strengths and work as co-operators rather than competitors.

I have personally witnessed successful private/ public partnerships in Australia where the private firms manage all the administration and financial and business of running the practice whilst the doctors focus on clinical services and this seems to be an effective business model. No reason why it shouldn't work in the UK.

The doctors work as subcontractors so have their own autonomy in this co-operative partnership and profits are split between the participating Gps and the private company to meet the costs of administration, staff and nursing costs.

Summary of Key points.

t will not be long before this marketplace will be highly competitive.
It will all boil down to too few contracts being sought by many independent providers.
To survive this change in the marketplace, surgeries might think of strategizing to survive in these changing times.
They can merge forming superclinics, or form partnerships with secondary care or in certain cases with private firms.
In creating partnerships with Private enterprises it is important to do due diligence

Until Next Time,

Dr. Lorna Knight

Locum Survival Tips! (Part 3)

2011-07-19T04:58:00.000-07:00

Locum Survival Tips! (Part 3)

In this 4 part series, I will discuss Locum survival tips which I have found useful.

5 Tools & tricks that are important to have as a locum.

I am going to suggest a list of handy items, which apart from your doctor's bag you might arm yourself with...

1 Carry with you a copy of your CV.

This can be stored in a USB or in a floppy disc. Sometimes I have been asked to give my CV to a partner when I have worked in a practice looking for a long term locum. If you have it at hand, not only does it mean that the principals can gloss through it and not forget you after doing that “ irregular session”, it means it increases the chances of you being shortlisted for an interview should they be looking for a partner.

Don't forget that they receive hundreds of CVs and the chances are increased of you being shortlisted if they can put a name and a face (and a voice) to a CV.

2 Keep your contacts organized in Style.

It looks professional to have a Rollodex or a diary to transfer details of contacts that have been scribbled on pieces of paper or dinner napkins. If you save them on your mobile phone, Iphone, pda, notebook or blackberry be sure to do this separating business contacts from personal contacts.

3 Business cards.

Not many doctors carry around business cards with them but they serve a very useful function. They are especially handy when networking or at educational seminars when you want someone to contact you.

The cards should be designed to contain at least your personal details such as your name plus up to date contact details and the organisation you work for.

Additionally, you can include more information such as mobile no, email, LinkedIn details and in fact the more the merrier. There's no rule stating that business cards only have to have a phone number!

Many times I have found that even if you do no get a phone call in the following month from that useful contact, there is a greater chance of future contact if that precious business card is held on file by the contact. Many opportunities can be lost if you come across as being scatty and disorganized especially if you hand in your contact details on a dogeared piece of paper with your name.

4 An electronic file or workbook.

Stored in a USB or floppy disc or smartphone or ipod, they can be always updated opportunistically whenever you attend a lecture, have a clinical governance meeting or do an audit. Believe me, it will save you from the mad rush 2 weeks prior to the time of your appraisal when compiling all the events and evidence of learning!

5 A means to de-stress.

There are many situations that may arise that can be stressful whilst working in general practice. It is important to make sure that the tension or angst in these circumstances is not transferred to other members of staff and/or the next lot of patients that you see.

If you have not attended any neuro-linguistic programming courses which show you how to switch from this negative state to a happy state, sometimes physical tools can be used :

5.1 Stress ball. These malleable toys can be a useful tool in relieving stress and come in all shapes and sizes. When confronted with challenging situations in our working lifes, especially when we are called to refrain from expressing our innermost feelings towards the perpetrator, these balls offer a means to release inner tension. They come in novelty shapes too...!

5.2 Ipod. Apart from the fact that Ipods and iphones have several medical applications ranging from useful resources such as Eponyms, surgical atlases, Netnewswire, one can listen to the tunes which can help relieve the tension.

5.3 Share Your Feelings!

You already know it's not good to bottle things up. So do something about it. If you can't talk to your friends, family or peers about it then go online. You can use the forum I setup if you like, that's what it's there for!

Hope this helps, more to follow.

By Dr Lorna Knight, a GP and a christian. www.GladClinic.com

Lorna's Locum Survival Tips! (Part 2)

2011-06-27T22:13:00.000-07:00

FINDING A NICHE TO EXCEL IN.

To stand out today one has to be prepared to take the extra mile. There are thousands of "world-class" doctors, neurosurgeons, and it can be a challenge to stand out.

(1) Be proactive: In this competitive marketplace, more so than ever, one has to seek opportunities. If you have read "The Secret" authored by Rhonda Byrne, a philosopher, the principle of attracting opportunities by thinking and visualising and feeling opportunities that bring wealth and health is widely advocated.

Find out "What's on?

What's on at the clinical governance meeting of the Practice that you are locumming in?
Are there any audits that you can undertake?
Can you employ your IT skills where it is apparent that there is a need that you can fill?
What's on the agenda of the Local medical committee?
Are they seeking clinical engagement?
Is this an opportunity to volunteer as the GP representative for your local Prescribing executive committee?
What's on the menu of educational events and symposia organised by the postgraduate secretary?
Is this a chance to update the skills and earn CPD points?

I attended a lecture by a Sports physician who was responsible for the British rowing team. He let slip that they were crying out for doctors who were Sports physicians to manage the teams.

The London Olympics presents a plethora of opportunities. Might it be an opportunity to undertake a course in Sports Medicine.
For further information on education by the British association of Sports Medicine and online courses supported by BMJ go to the following website
http://www.basem.co.uk/index.php?PageID=1090 .

There are even scholarships for the pickings for clinicians. For example The Malcolm Read award will provide financial assistance to support a BASEM member who wishes to undertake professional development in overseas centres of excellence. The idea is to reward work by a clinician, who, in the tradition of Malcolm Read, contributes to the practice of Sport and Exercise medicine by using practical/clinical experience to shape thinking within the field.

What's on the list of skills and requisite qualities for those who make up GP commissioning consortia? How can I Skill Up? There are many support structures in place; the Royal College of General Practitioners has a series of workshops for Gps, nurses, GP consortia:
http://www.rcgp.org.uk/centre_for_commissioning/workshops.aspx .

The MDU has a GP commissioning training program. If unsure as a first step speak to the Practice and find out if there are any principals/partners in the local GP consortium and find out how to get involved.

(2) Hone your skills and be prepared to take direction from those who are at the top of the game. It is advisable to have mentors and if you do not, I recommend that you find someone, even if it is not exactly to progress your career but to offer moral support.

Not only will they be instrumental in helping you make that quantum leap, from where you are today, mentors help you focus and guide you.

For example if you have excellent communication skills hone your negotiating and presentation skills, take advice and learn from experts - watch contract lawyers negotiating contract deals and drawing up comprehensive service contracts and practice and practice and practice presentation skills.

There is a glut of doctors in management and leadership positions, in health policy and decision making yet we are at the frontline and at the centre of patient care.

Choosing your mentors has to be a carefully thoughtful process. For example in this case, you could ask a Medical Director of a Hospital trust or a trusted lawyer friend.

(3) Differentiate Yourself.
No one expects you to find a cure to the cold or send a spaceship to the moon. You can do this by first researching the marketplace and finding what the market needs.

You are then in a position to make clear goals on how to attain the skills to meet the needs. If you demonstrate a willingness to learn and are flexible enough to rise up to challenges by researching and asking authorities for help you will find that you are better placed and prepared to take on extra challenges and that you are not short of work opportunities.

Be flexible and take up extra courses that are on offer. Allow yourself to tread on paths that your contemporaries have not chosen. Don't be a 'me too' and this way you can accomplish your goals and dreams. Think outside the box.

(4) Volunteer and/or work for associations or charitable organisations.
Many a career has been charted through voluntary work.

Bill Gates and Melinda Gates Foundation, William J. Clinton's charity are a couple of quick examples of charities that employ healthcare professionals.

Hope this helps, more to follow.

Dr Lorna Knight, a GP and a christian. www.GladClinic.com

p.s. Please pass this on to any other doctors or surgeries that want to stay in contact contact about locum opportunities - it's a free but recommend-only service.

Lorna's Locum Survival Tips! (Part 1)

2011-06-12T02:49:00.000-07:00

In this 4 part series, I will discuss Locum survival tips which I have found useful.

(1) Always remember that the key reason why you practice as a doctor above everything, is to care for the human race.

In everything you do, put the patient first and you will find that everything else follows.

We all have needs and aspirations. Besides fulfilling basic human needs ie paying off the mortgage and other bills, we all aspire for good things. For example, I always wanted a high performing sportscar and it was handy to have extra pocket money to pay for the tracking service, the higher insurance costs and extra gadgets that I could use whilst driving - like a dvd/mp3 and ipod docking station in the car.

However, if all you are motivated by is the acquisition of more things, it will be pretty obvious in the way you come across to both the patients in the surgery and also the staff.

Believe me, if your only key motivation is to locum to earn the means to acquire more stuff; the good news is that you can possibly do this but the bad news this will not last.

Your key motivation should be to do your best to care for patients. Work with excellence. People round you will notice your enthusiasm, your kindness, your warmness and you will get surgeries asking you to come back again and again.

Instead of having to ask around, practice managers will clog your voicemail with requests and you shall not be short of work.

(2) Always remember to Listen.
Listen to your patients. My trainer always used to say that the first 2-3 minutes
of a consultation can determine how a consultation pans out.

If you listen to your patients and not talk over them or interrupt in the first 3 minutes, you are more likely to pick up cues, anxieties and their own ideas for the illness
or presenting complaint you will be able to deal with the consultation as efficiently and in reasonably satisfactory manner.

Patients do not like feeling rushed and the highest cause for complaints is not because a doctor gave them the wrong medication but because they felt they were not listened to and that the doctor was "abrupt" or "rude."

I am not saying someone should change their personality. Really listening to patients could mean shorter consultation times, more satisfied patients, less risk of receiving a letter of complaint and the dreaded GMC (General medical council).

It also means the patients will ask for you and practice managers will request you to come back. For those seeking partnership positions, listening is such an essential part of networking. There are many instances when one picks up snippets of conversation in a practice that give you an idea of what the ethos is like, what the current partners would like, where the needs are in the practice.

By simply listening, your career could potentially thrive. Not listening is career suicide.

(3) Invest in Social Capital. Take an active interest in the people who work with you. Encourage people to talk about themselves.

How many locums are known to come into a practice, get their head down and not to talk to anyone except their patients and occasionally,
the ICT manager, the receptionist and leave for home.

( I realise that sometimes it can be really 'full on' leaving little or no time to socialise)

My advice is that sometimes just spending 5 min, speaking to the members of staff can really make a difference in whether or not they determine
that you are personable and approachable.

If you do not know what to say, there is a simple formula which I learnt and picked up from a seminar -that I attended last year -"Secrets to Success" by Dani Johnson.

The formula is FORM. For those who like myself struggle to break the ice with
strangers, I found this formula very useful.
F-family
O-occupation
R-recreation
M-message. You can choose and pick F and R which stand for
family and recreation in this case.

What on earth has this formula got to do with your survival as a locum? Well, if you do at least say "Hi" to the receptionist and centre the conversation on asking her how her family is doing and what her recreational interests are can sometimes help to break the ice.

Receptionists are on the receiving end as they are the front end of the practice, taking calls from often irate and vexed patients and their jobs are not easy. A kind word to them, boxes of chocolates, even speaking to them go a long way in establishing a good working relationship. I can assure you that this isvery important.

There have been several instances, when receptionists have talked to me in
advance and warned me about some patients who will be demanding for certain medication and to not offer it because they have been already prescribed it by their "regular" doctors.

This information is often important because some patients can take advantage when they know you are a locum. Not all practices have special notes about patients in their records and hence the importance of making sure you use whatever resources are
available to make your work as easy as possible.

People are an important resource!! Do ask questions ... never, ever be afraid to ask questions.

You will find it a lot easier if you get on with people. Take part in partners meetings and learn by listening and taking an interest in
what they do outside of work.

It will not only show that you have a "human" side to you apart from your "doctoring" duties. You will more likely be invited to do more locums and if a partnership opportunity arises, you will be in the know before your contemporaries do.

I am afraid there is no other way but setting time aside to do this and if you are terribly shy, use the "FR" of the acronym for networking "FORM" I would strongly recommend the following books:

How to Win friends and Influence People by Dale Carnegie 1936
http://www.westegg.com/unmaintained/carnegie/win-friends.html
"We demonstrate interpersonal intelligence when we recognise and are able to discern feelings, emotions, moods and react appropriately" and this is a key determinant of our career success as doctors.

This requires empathic listening and caring feedback. A key resource on the value of Emotional intelligence is an article by Dr E. Scott Geller

http://www.safetyperformance.com/Articles_1996/TheValueofEmotionalIntelligence.pdf

(4) Have a sense of humour. Do not take yourself too seriously. It goes without saying, general practice is a stressful job.

There is no harm in having a sense of humour. The team you work with will value your company - Nothing makes life a lot easier than having a cheerful spirit even on a "snowdowned", "down" day. If you send positive vibes when you are around, you are more likely to be invited back to work whereas if you carry with you "buggage" and are uptight and carry a sullen face, it is more than likely that the practice will find it uncomfortable to be around you and are less likely to want you even if you are a super-duper, competent doctor.

(5) Get your priorities right. Make sure you have plenty of rest and look after yourself. No one will do this for you!

You have to draw some boundaries and actively seek a good worklifestyle balance enabling you to get enough rest and family time whilst working at the job. Keep revisiting this periodically because it is very easy to get carried away and work yourself to a grind.

No one wants a sick doctor. Make sure you take breaks when you are given them and also request them especially if you are the on call
doing triage and there seems to be an interminable deluge of patients and requests to see emergencies.

Hope this helps, more to follow.

Dr Lorna Knight, a GP and a christian. www.GladClinic.com

p.s. Please pass this on to any other doctors or surgeries that want to stay in contact

Hello World!

2007-04-17T15:10:00.000-07:00

Hello folks.

My name is Lorna and here's my blog!