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February 14, 2018
As the complexity of primary care finance and logistics becomes ever more byzantine, it’s essential to have someone in place who has a very firm hand on the business tiller and whose commercial expertise allows the GPs to get on with the clinical job in hand.
Having an astute, committed practice manager on your team can make a massive difference to both the business and clinical sides of your operations, and keeping this sort of employee happy and incentivised should be a practice priority.
One way of doing this that we’ve seen occurring more frequently in the last couple of years is inviting a practice manager to become a partner, and while it’s still not very common, all the ones that we have seen come to fruition have been very successful.
Technically speaking, there’s no difference between clinical and non-clinical staff becoming a partner in a primary care practice, but there are a few practical differences that need to be taken care of to give such an arrangement the best chance of success.
As with the formation of any partnership agreement, an open, clear conversation on what both sides would want out of and could bring to such a relationship should be the starting point.
All red line issues need to be clearly covered off from the beginning, as there’s no point wasting everyone’s time if there are things that will make any agreement a non-starter that could be identified early in the piece, and the way in which partnerships actually work needs to be understood by the potential new recruit.
The facts that the practice manager would become self-employed, and that the value of the profit share from which they will derive their future income can go up and down should be made clear, and the different levels of profit share that the GPs and practice manager are likely to receive should also be agreed.
In theory, a practice manager could receive their P45 and sign a partner agreement on the same day, but it’s likely to require a bit more time and careful consideration than that, and it makes sense for all parties to talk to professional advisors about things like the tax implications of these arrangements, as well as the general ways in which it will impact on their earnings.
In the practices where the manager has become a partner, the increased incentive that it has provided has seen all of them record an increase in profitability, which in turn feeds back to both partner earnings and the services that the practice can provide.
It’s a move that won’t be for everyone, but if your practice has a manager whom you think you’d find hard to replace, there’s no harm in looking at it as one way in which they might be encouraged to commit themselves to you.