A Family Doctor's Tale - GROUP PRACTICE LOCUM

GROUP PRACTICE LOCUM

My wife and I have decided to set up a small family clinic in a new housing estate near our house about to start in 1974.

In the meantime we have to earn enough money to set up the clinic. 
I had an offer from a group doctor practice to work as a locum for 3 months. 
I requested a monthly salary of $2000 which was very high at that time. 
It was necessary as I had to travel down to the busy central business district and I had to do night duties.
After an interview with the senior doctors in which I showed all my earnings on a commission practice from the run down clinic, I was employed.

Group practice was basically differently from a solo medical practice.
There were many partners each with different attitudes to work. Besides their income comes mainly from big contracts with companies. 
They have clinics in the factories, hotels, port authority, telephone companies etc.
Generally there were less family patients although some of the doctors do have a following of private patients.

There was a laboratory to do blood tests, ECG and Xray facilities all inside the clinic. 
Since one of the doctor was a surgeon, there was also an operation theater.

Medicines provided were mainly branded except for the medicines in the factories.

There were quite a few receptionists, clerical staff and nursing staff.

It was entirely different from the solo family practice I had done in the rundown family clinic.

Still it was a challenge . 
I learned I could about contract medical practice and made friends with all the patients and people that I met.

I learned from one of the more friendly doctors( a junior partner who was previously an assistant but left because he was not given his partnership as promised)  about:

1.how to remove lumps and bumps
2.how to incise and drain abscesses
3.how to inject into joints with intrarticular medicines
4.how to inject into hemorrhoids
5.how to do a plaster of paris cast for fractures
6.I also learn how to see patients fast especially in factories.

There were factories visits, hotel visits, ship calls to give vaccinations to the crew, and work at different clinics.

I learned to do all these and added it to my experience later in my family clinic.

The problem with group practice was the inequality and in fighting of the partners. 

The senior partners were reluctant to give partnerships to their assistants whom they have promised partnerships. 
The assistants felt they were doing all the work in building up the clinic and yet not given the recognition and partnerships that they were promised. 
 Some of the senior partners felt they were doing more work than the other partners. 
So nobody was really satisfied with the group practice. 

At the time of my locum 2 of the assistants had left because they were not given their partnerships while the 2 who stayed fought on their behalf. 
It explained the urgency why I was employed to fill in the gaps left behind by the resignations.
Eventually all four assistants were made junior partners because they were needed to do most of the work. 

I was the only non partner in the group which was why I had to do a lot of factories work and house calls.
Still I got on well with most of the junior partners. 

In fact one of them taught me a lot about group practice and all those surgery and injections which I spoke of earlier. He also felt that there were too many house calls that I have to do and volunteered to do some for me. 

Up to today he is still one of my best doctor friends.

Some of the senior partners were not on good terms with some of the junior partners and also among themselves.
There was always this sense of animosity between the partners. 

That is one of the reason I did not like group practice.