Sharing workload in group practices

Editor—Branson and Armstrong studied general practitioners' perceptions of sharing workload in group practice.¹ The thorny issue they mention of who might not be doing their fair share of work is not an issue for my colleagues and me as we work with strict personal lists, list sizes being adjusted to allow for less than full time commitment. This means that we all have the same potential workload, and if some of us are less efficient at managing it there is no spillover on to other colleagues.

Figure 1.

Credit: JIM VARNEY/SPL

Having a clearly identified doctor of prime concern means that each patient is “sorted out” by one partner rather than being passed around like a baton in a dysfunctional relay race, with the assumption that somebody else will be the one crossing the finishing line. It also enables us to deal with clinical governance issues much more easily as the audit trail is easier to follow. Knowing your patients can save a lot of time during consultations, and it is my experience that patients are less likely to lodge a complaint against a general practitioner with whom they have a longstanding relationship than with one whom they have only seen a handful of times.

Many believe that the personal list system is an anachronism. I beg to differ. I believe it is the formula that can ensure that primary care can deliver personalised continuity of care while maintaining high levels of job satisfaction for those of us occupying the hot seat.