Nice little job in a GP Practice

Written by: S.Black

I’ve read a lot in recent years from practice managers who want to form their own professional body, it’s an interesting one as whilst I agree that we are a group of professionals and we should have some form of representation, I think that we will always come up against the same problem…a total lack of understanding of what a GP Practice actually is, and even less comprehension about what a Practice Manager does.

A good example of this is something that happened to me recently, when I (for my faults) attended an informal school reunion. At first it was all hugs and recognition, then came the standard questions;
Are you married?
Do you have children?
Where do you live etc. etc. until finally, we came to what could be the most boring question of all time…what do you do?
I cringe at this question as I don’t think the sole measure of a person is their occupation, and so when I was asked this recently, I began, ‘I work in a GP practice.’
 To which came the response (and not for the first time)
 ‘Oh are you a receptionist?’

The person I was speaking to knows that I’m not a doctor, they know I didn’t attend medical school, and therefore it’s interesting to me that the first place their mind went was reception. Now, before I continue let me state categorically that I was not offended by this question, and that I have more respect for our reception team than any other team in the practice. As far as I’m concerned, they have the most difficult job in GP land; it’s thankless, relentless, and woefully underpaid across the country. The reason I found it interesting, is that public perception of GP practices seems to be this; that if you work in a GP practice, you’re either a doctor, a nurse, or a receptionist…and nothing else.

GP land is like a hidden world that outsiders don’t understand; filled with challenges and triumphs that simply do not occur in other industries, even in other parts of the NHS. Forget anyone in the private sector if you’re looking for understanding because the fact of the matter is, practices exist on their own plains, and we must accept that the public simply cannot comprehend what we are dealing with on a day-to-day basis.

I remember, several years ago, a rep from a company coming out to our practice and making an offhand comment about practice managers never working full time, the implication from her tone being that PMs don’t really do that much. I was furious but being a relative newbie myself I kept my own counsel. I’ve often thought back to that day, and the fact that the rep professed to understand how practices work and to recognise the pressures we face, whilst at the same time openly criticising the fact that a practice manager didn’t work 5 days per week. I never told her that the reason the PM only worked 4 days a week was because she worked consistent 12 hour days, well over standard full time hours, doing most of her admin at home on her ‘day off’.

Which brings me back to my opening point. People, and by people, I mean anyone who has never worked in general practice simply cannot understand, comprehend or believe the work that we do. They do not understand the vast complexities of our targets, the way that we are paid, the structure of staffing or even the fact that we are essentially independent businesses and what we need to learn to accept is that they never will.

I know that people on the outside think I’m being dramatic when I explain my role, that it is business manager, HR manager, contracts manager, finance manager, IT manager, complaints manager, maintenance man, snow shoveler, staff counsellor and more all rolled into one. But it’s the truth, and other PMs will read this and nod their heads because undoubtably you too have seen someone glaze over when you try to explain exactly what it is you do.

So what can we, as PMs do about this?
Honestly?
Well, nothing really. Other than alter our way of thinking about it.

I refer to two characters from fiction to illustrate my point. Clark Kent and Harry Potter.

Let’s start with Harry Potter, it’s a nice easy analogy that we can all relate to. We work in a world that outsiders (let’s go the whole hog and call them ‘muggles’) simply do not understand. They don’t believe in it, they think it’s as simple as just hiring more doctors or just getting more receptionist and they have no idea that there is a whole world of practice staff working away unseen in the background; clinical coders, reports administrators, clinical administrators, medical secretaries to name a few. Until you become part of the mystical world of general practice you just don’t get it, you’re not in the club, because you’re a muggle, and we are magic.

In case you’re not a fan of the wizarding world, let’s take a look at the classic caped crusader instead, Clark Kent, who worked a normal job, and looked, from the outside, like a normal bloke with nothing special or interesting about him, until things went wrong and suddenly, he was ripping off his shirt, throwing off his specs and saving the day as Superman. As Clark Kent, he took none of the glory, and just did what he had to do until it was time to be his true self and save the day. He couldn’t tell his colleagues in the office how much he was doing behind the scenes, and although we as PMs can, it is pointless, so we don’t.

Why have I leapt to Superman you might be thinking?
Well, consider this…

When the pandemic hit all hell broke loose, and GP practices were being slated left right and centre. The government were chastising us for closing our doors…which was a load of rubbish in most cases, and criticising GPs and medics for taking government mandated precautions like reducing unnecessary F2F appointments to lower the risk of spreading the virus. We were openly criticised by our patients and received record numbers of complaints across the industry simply because we were trying to keep our patients and our staff safe. We were Clark Kent, beavering away in the background, working from home when suffering with covid ourselves and receiving no real thanks once the public became sick of clapping for the NHS.

But who was it who got the nation vaccinated? The mass vaccination sites? No. It was GP Practices. Like Superman emerging from the toilet cubical Clark Kent formerly occupied, we rose up as a group and facilitated the mass vaccination of the most vulnerable and at-risk groups in the country. Don’t get me wrong, vaccine sites did their share, but it was GP practices who ensured that the people who were at most risk were protected from the effects of Covid. And no one can ever take that away from us. We did it without fanfare, and then we did it again, and again, and we’re about to do it once more and no doubt there will be those who criticise our management of the vaccine programme this time round but who cares? They don’t get it. They’re muggles, and we are magic folk. They aren’t in the club and so they’ll never understand.

So the next time I tell someone where I work, and they ask if I’m a receptionist, or they make the classic comment ‘Oh, a nice little job in a GP practice’, I won’t flinch, or lose my temper, or even attempt to explain why they’re talking out of their rear.

Instead, I will simply smile and nod, and as they walk away, I’ll mutter to myself with a sigh and a shake of the head…’Muggles’