Good Practice - ‘The Seven Ages of a Doctor’

A doctor’s career will go through many transitions: from earnest medical student to sleep deprived hospital doctor, from a busy life in general practice to an active retirement - all the while trying to manage family life, earn a living, and hopefully find some time for hobbies along the way.

With each transition comes fresh challenges – some will be exciting and invigorating, and some will be difficult and stressful. Whatever the transition, doctors need to think ahead and plan for significant career changes.

In this newsletter we look at an increasingly common transition, from the perspective of two Sydney doctors: moving from a privately owned practice to a corporate practice.

seven ages of a doctor

Dr Michael Chambers: “It’s a great way to bundy out of general practice”

Dr Michael Chambers is a seasoned GP who has worked on Sydney’s Northern Beaches since the mid 1970s. He’s from the old school of general practice - 24 hour on call, cradle to grave, home visits, and delivering babies - 2000 of them at the last count.

When he started his career, Dr Chambers worked solo or in small practices. By the late 1990s he was running what he describes as a “boutique practice” with two associates.

“I was as busy as a bee and as happy as a pig in mud”, he tells me.

But by the time he entered his fifties, Dr Chambers started to think about the future. He was still passionate about medicine, but he wasn’t so keen on spreadsheets and BAS forms.

He wanted to lay down a new path for the future that would allow him to slow down a bit, but also ensure his loyal patients were getting good care.

He amalgamated his practice with another local multi-doctor practice and they brought in a management company to handle the day-to-day running of the business.

It was a disaster.

The management company collapsed owing millions, including to them. An expensive, energy-sapping court case followed.

Despite this setback, the practice itself had been a big success.

“I think it was because we were practising good medicine, and we had good rooms and good staff”, he says.

Now older, wiser - and poorer - Dr Chambers was forced to look around again for management support. This time he and his partner chose the corporate route and joined a major operator of general practice medical centres.

Before signing up, Dr Chambers had some concerns.

“I didn’t want them to force me to see a lot of extra patients. I wanted to practise in a similar style, and with the same ethics, as I had done in the past. I didn’t want them to dictate how we practised medicine”.

Such concerns never arose, he says.

“It turned out to be one of the best things we’ve ever done professionally”.

He also enjoys the collegiality of the now large practice.

“We’re working with each other. We’re stimulating each other. And we have visits from other health professionals to stimulate us even further. I think my medicine has improved since I’ve become a corporate doctor”.

Dr Chambers turns 70 next year and is looking forward to handing in his stethoscope and leaving behind a happy, well run practice.

“It’s a great way to bundy out of general practice”, he says.

When I spoke to Dr Chambers it was late on a Wednesday morning and he had just finished one of his regular bike rides. He now works three days a week.

There may have been some bumps along the way, but in Dr Chambers’ transition from private practitioner to corporate practice, the road to the finishing line of his career has been made a lot smoother.

 

Dr Margaret Gottlieb: “I was really run off my feet ...And I just thought: I want to stop doing this”

After graduation Dr Margaret Gottlieb spent five years working in hospitals as a paediatric registrar. In 1981 she started a general practice in Sydney’s Inner West.

“It was in a little house, basically. It was a sort of cottage industry general practice [with] a bunch of women all working part time”, she says

For the next two decades she happily plied her trade and then at the turn of the century she made a momentous decision.

It was the early days of corporate medicine in Australia and one of the big new medical practices was setting up in her area. Dr Gottlieb was cagey, but interested.

“I was really run off my feet. I had three small children. I was running a business. I was employing people. I had to work a lot of the school holidays. And I just thought: I want to stop doing this”, she explains.

So she jumped – on a handshake agreement. Almost from the beginning it was a bad fit.

Despite earlier assurances that she could continue to bill privately, they insisted she bulk bill. The company complained she didn’t see enough patients per day. Then they insisted she use their radiologist, which she declined to do. It wasn’t how she wanted to practise medicine.

Dr Gottlieb happily admits to a stubborn streak, and she worked hard to make the deal work the way she was comfortable with, but after eight years she’d had enough.

“I can’t say I was happy there, but I tried to make it work for me”, she says.

In 2008 she shifted to her husband’s small private practice on the Lower North Shore, many of her patients followed her across the harbour - and she hasn’t looked back since.

Today she is what you might call a ‘portfolio medico’: she works part-time in the practice with three other doctors; she lectures at a university; and she works in mental health.

Dr Gottlieb is also writer who maintains an active cultural life. When I spoke to her she was just back from spending a long weekend at the Bellingen Writers’ Festival. She’s also involved with Creative Doctors, which highlights the creative things doctors do when they’re not being doctors. Each year they organize literary and visual arts events and performances.

“In fact, I should wind back something, but I don’t know what to wind back because I really like it all!”

But with two elderly relatives to look after, and poetry to write, at least she now has the option of reducing her workload with relative ease if she feels the need.