Trailblazer
move on. We just couldn’t do that. On big issues, they were even more indecisive. When we entered the agreement, we knew that part of the plan was closure of smaller practices to establish a big one.”
Dr Patrick McGonigle and (inset) from an earlier Medical Forum story circa 1998
“Small practices know each other. If we had a problem with staff, we sorted it in a day. Things weren’t allowed to fester but the delay with the chain of command, left people wondering and worrying.” It was this corporate indecision that was the final straw for Patrick. “We would wait sometimes up to four weeks for decisions – some of them very small in the scheme of things – to come back from head office. That became frustrating.” “I’m no empire builder but I like to see a problem and make a decision to fix it and
“I wasn’t against that but we were getting mixed messages that made us wonder if it was ever going to happen. We came up with some compromises but they couldn’t decide about them. I was heading out of contract in February 2004 and I didn’t have a renewal proposal in front of me by the time I took a week off for Christmas. Eventually it was this indecision that persuaded me to leave and I wasn’t the only one.” There has been considerable rationalisation in the corporate primary health sector over the past 15 years, with mergers and closures leaving a playing field of four major companies operating 69 medical centres in WA – IPN, Sonic Health Plus, Healthscope and Primary Health Care. It is hard to separate the general practice revenue from the balance sheets, but it is fair to say they are largely profitable and that they are vastly different enterprises to the early days of corporatisation. One firm, IPN, states on its website, for instance, that only 15% of its
medical staff is on fixed-term contracts. The rest are independent practitioners. For Patrick, the return to self-determination was initially daunting. “My first reaction to the suggestion of relocating and starting a new practice was to ‘run for the hills’. But after a drive-by the Gwelup property, the future began to take shape. The uncertainty of the past three years meant that Gwelup began life with a team of doctors and administration staff from Kingsley. “We had experience and the team which meant we could start up immediately when we moved here. We knew each other and the future was in our hands.” While Patrick acknowledges that running a practice with all its complexities is not for everyone, for him and his partners, it’s a question of growing together as a team and growing older with their patients. There is also a commitment to training. After hosting medical students for a few years, GP training is once again on the agenda and while many might see this as more work, Patrick says it’s vital. “We need more doctors and ultimately it’s an investment. Two partners are former trainees of mine. Hopefully, when we start training and it will grow again.” “That’s the thrill of running your own practice. You are the master of your own fate. It is what you make it.”
By Ms Jan Hallam
smithcoffey
MEDICAL FORUM
19