One of the wonderful things about being a GP is the flexibility that it offers you. One of the protective factors against burnout is to have a special interest or project that you want to do. As a GP there are many options that you can do alongside day to day General Practice. Below are some examples of how doctors have blended clinical practice with other activities or roles.
Working as a Portfolio GP - Dr Luke Turley
I have had an interesting career so far. Whilst it just seems normal to me, when I tell other doctors what I do for a living, the reactions vary from surprise to confusion, although I can’t imagine myself in any other job role.
I completed my MRCGP and GP registrar jobs in 2008 and at the time expected to follow the normal career route of salaried GP with eyes on a partnership. When I started applying, however, something didn’t feel right. The thought of tying myself down to the same practice effectively for the rest of my life did not appeal.
Since then, I would describe myself as a locum, but it has now been many years since I have stepped foot into a “regular” NHS GP practice. During this time I have had the opportunity to work across a number of different sectors, including prisons, military bases and makeshift field hospitals. In just the past 12 months I have worked in Portsmouth, Dorset, Sierra Leone, Brunei, Uganda and Cyprus. Prior to that I have had work trips to India, Kenya, the Philippines and Dubai.
Working in the prison sector has been fascinating, and not in the least bit scary! The secure nature of the prison environment brings its own challenges, from the physical environment (having to get your tendon hammer out of a locked cupboard every time you use it), through issues in consultations (be that dealing with acute substance withdrawal or drug seeking behaviour), all the way to thinking more about your prescribing (every drug you give out can be used as currency!)
I enjoyed the prison work so much that I ended up setting up my own company providing medical services to prisons and other secure locations. The five years I ran this company brought its own challenges, but I left the company having gained the experience of how health services are commissioned, how to write a successful bid, how to deal with politicians and commissioners and how to keep services going without running out of cash!
As part of this work, I got the experience to work with alleged victims of torture. Despite the harrowing stories they told me, this work was rewarding. I was able to use this experience and set up training for doctors throughout the UK on recognition of victims of torture. This work even got me invited to Parliament to advise a committee run by a member of the House of Lords, as well as speaking in a number of conferences.
Working as a self-employed portfolio GP has allowed me to follow other clinical interests as well, without feeling tied down. One of these is sports medicine. I am currently studying for my diploma in sports medicine through the International Olympic Committee, and as part of this I am on the short list of doctors currently being selected to work at the 2018 Winter Olympics. Over the past few years I have been able to combine this interest with other work I do, such as dive medicine, but also expedition medicine. Last year I was clinical lead for two international marathons, one in Sierra Leone and one in Uganda. Although the race was only one day for each trip, me and my team provided medical cover for all the runners and volunteers throughout their trip. This meant that in the course of the trip we saw and treated everything from running injuries, heat stroke and blisters all the way to snake bites and road traffic accidents.
For part of the year each year I work with the military as a locum civilian GP. Although you get some routine GP cases in these clinics, due to the younger and generally fitter population you get the chance to see very different pathology. These locum posts also give you the chance to work overseas. In the past few years I have been able to work with the Army in Kenya, Brunei and Cyprus (from where I am writing this). Whilst clinics here are generally less busy than regular NHS GP clinics, you see a wide variety of different cases and the job requires a slightly different skill set. For example, just today I have seen a child who was bitten by a camel spider, a lady with a jellyfish sting, a fractured humerus from falling off a mountain bike, and been out in my “blue light” car to attend a four car RTA.
A lot of the work I do involves working through a locum agency. This is the nature of military and prison contracts. As with anything, it has its pros and cons. Unless you are sent to an NHS GP practice you can’t pay into the NHS pension, and your rates of pay tend to be set by the agency, however on the plus side, they have dedicated staff desperate to find you as much work as you can cope with. I have never had to worry where my next shift will come from. They also ensure you get paid in a timely fashion. Providing my invoice reaches the agency by Thursday morning, I am paid by 9am that same Friday. I have never had to chase a payment!
Although my life may seem to some a little bitty and nomadic, I cannot imagine it in any other way. I wake up every day looking forward to going into work and despite the odd frustration, can honestly say I have loved every minute of my career and would not change it for the world.