Feeling valued as a GP in Primary Care
A roadmap to feeling valued.
The role of a GP is intense to say the least.
Most GPs can be considers as technical experts in the delivery of broad medicine. At the front of the NHS, a GP will meet a vast number of patients and be tasked to make clinical pathway and treatment decisions in a matter of minutes, on loop. To such an extent that I’ve met GPs who struggle to discuss anything for longer than 3 minutes, the counter to my problem as a Psychologist — being unable to discuss anything in under 60 minutes!
Beyond the role of being a pressured jobbing clinician there are a legion of additional demands including dealing with complaints, medical crisis, personal development, covering for sick colleagues, admin, new technologies, constant change and for many, the ownership and leadership of a small business.
A lot.
But as you will know, many GPs take on additional roles that tap into their special interests, including new clinical skills, leadership and consultancy.
The life of a GP is often packed.
Primary Care teams often perceive GPs as the top of the pile. Owning the business, reaping the profit and holding the power. Of course, this is true — but the culture of the team and how the team feel is not a direct outcome of this, it is an outcome of leadership.
One outcome, which seems not that uncommon, is that GPs can feel undervalued in their own teams. Either through a direct sense that they are isolated or as an outcome of confidence issues in the role of leadership. They can feel unheard, unappreciated and frustrated.
Here I will offer some insights I have learned from supporting GPs towards better connections with their team and a felt sense of value.
- Recognise your role and stick to it.
Many medics have learned to try hard and to over deliver in the world of the NHS. The system rewards effort and there is a definite culture of presentism — where long shifts and turning up are acknowledged as positive traits. As a GP, you no longer have anything to prove, rather you have a business to succeed at leading. Being right is second to being profitable and pleasing patients (which are mutually co-dependent in a business sense).
Being a good GP and having a good business head are now priorities and you may need training in the latter. When we feel weak in one area, we lean on the other more. Many a primary care board meeting is spent arguing about clinical issues whilst the issues of business draw less interest, beyond panic when things go wrong. It is difficult to feel and express value, when we are masking our anxieties with ego and dominance.
2. Be intentional about value communication
Communicate value in your practice. At the board level, in meetings and in 1 to 1s — notice value in others and state it. Compliments, appreciation and verbal reward are fuel to teams. The NHS often just expects us all to turn up and work hard, because we do. Remember though, you own a business and this is a different position than many in your team. Being a positive value spreader is going to encourage the same back. It is surprisingly rewarding to lead on this and you will notice value given creates value back.
3. Lead a culture that notices value
Build value awareness into your meetings. There is a chapter later on noticing success that I recommend you reading. Teams that can see their successes and where they came from can also build on this to get more of it — in terms of outcomes and feelings.
4. Recognise others and self as people with needs
Healer heal thyself.
It is important to value yourself and to value others in your practice at the same level. We all need to feel valued and this has to be able to weather storms. Sick leave is a disruptor in Primary Care and can reduce empathy for staff who repeat leave. Anger in meetings, difficult staff, blockers to change — are all threats to team function. Value has to penetrate surface experiences of people, as we start to realise that all of these can stem from others feeling tired and undervalued. To avoid a circularity we need to model witnessing positivity even in difficult times.
I met a GP recently who had taken 3 months stress leave after his father died. He told me years later that he was so worried about himself as he was burnt out, but could not take sick leave again as his colleagues considered him to have had his “one shot at it” and it would be letting them down.
Avoid this culture. Name it if it is there. Look after each other.
5. Train up as a board member
I address this in the ‘Navigating the Board’ chapter, but I cannot stress it enough to GPs. If you want to feel valued and to declutter the business by reducing the effect of ego, control and power struggles — train up as a board member / chair. Encourage your colleagues to do the same. The more you can dettach from boardroom politics and the adolescent antics that sometimes come with untrained teams, the more you will all value each other as contributors to a business towards success.
6. Limit what you give
If you give too much, you will burnout or you will resent those who don’t match your contribution.
Give what you want to and feel comfortable giving to the practice. Balance this with life. Accept a pay reduction if you are giving less than others and see that what they give is needed. Be sensible.
It isn’t all about time and money, it is also about what you give to. Don’t volunteer for all the donkey work or projects nobody wants, learn to say no and learn to commit to what it important. All of this is addressed in this book, so read up and make plans.
Summary
Feeling valued is rarely about what others do — it is a reflection of team culture and how we lead, model and engage with it. GPs lead and own the culture, value is within reach.
Own it
Feel it
Encourage it