Real-life story - Dr Chris Warwick
Dr Chris Warwick is Head of GP training for Health Education England’s Kent, Surrey and Sussex team. Until recently he was a GP partner and now also works as an out of hours GP one day a week.
How I got into the role
I decided that I wanted to be a doctor when I was about 13 as I’d enjoyed sciences and wanted a stable career with a structure. The idea of doing a job that helped people might sound a cliché, but that was also an important factor in my career choice.
My family GP invited me to go with him on home visits, which I found really interesting. He was a welcoming and flexible role-model who inspired me to become a doctor. During the sixth form I enjoyed a work experience placement in a local hospital, which also helped me understand how the NHS functions.
I studied medicine at the University of Cambridge, and my five and a half year degree included two GP placements. During these placements I experienced the supportive and intimate atmosphere of general practice, which seemed far less anonymous than working in a large hospital.
After medical school I worked as a pre-registration house officer and gained varied experience in medicine and surgery. Foundation training is now its equivalent. I then spent six months working in A&E which almost became my chosen specialty. But in the end I chose general practice because of the continuity of care that the work provides and the unique interpersonal connection you have with patients.
Training to become a GP takes three years. I gained experience in GP surgeries and in several hospital-based medical specialties – elderly medicine, psychiatry, paediatrics and obstetrics and gynaecology. After this I spent six months as a salaried GP before becoming a partner.
After three years as a partner I became a GP Programme Director for Health Education England’s Kent, Surrey and Sussex team for one day a week as I wanted to become involved in education.
Whilst still working as a GP I was promoted to a new role as Patch Associate Dean which involved managing GP training in East Surrey. After five years in this role I moved into my current post.
What I do
As a GP partner you have much greater control over the organisation of the practice than is possible for a salaried GP. You’re still responsible for clinical work, but you also become involved in the wider decision-making of the practice and your voice is heard. Being a partner is very much like running a small business, a business that also involves clinical work.
Your work as a partner varies considerably between practices. Every practice employs a practice manager, but there may also be a business manager. When I first became a partner I was able to use my IT expertise to support the newly launched Quality and Outcomes Framework. This is part of the contract for general practices and provides incentives to GP practices to standardise quality of care.
If you decide to become a partner it’s important to find a practice that fits you. Each practice is run in a slightly different way, for example in the way that home visits are organised or the way your consultations are organised.
Being a partner can be financially attractive as you will get a share of the profits. And your income should be secure as your client base isn’t going to disappear.
As a leader, helping to develop GPs’ advanced communication skills has been an important goal for me. Excellent communication skills are one of the most important aspects of working in general practice. You often see around 20 patients in a half-day clinic, and it’s easy to miss important things if you don’t know how to listen effectively.
Working in general practice gives you the opportunity to develop outside professional interests and this broader perspective is vital. You can get involved in a wide range of activities including clinical commissioning, education and the GMC. As well as influencing in the wider sense, you’ll also develop your entrepreneurial skills.
I’m no longer working as a GP partner as my current job involves managing the GP training over the counties of Kent, Surrey and Sussex. However, I also work as an out of hours GP for a day a week to maintain contact with patients.
The best bits and challenges
What I enjoy most about general practice is the close interpersonal connections that you’re able to make with patients. The job gives me the opportunity to help patients develop an understanding of their own health, to explore current problems and mutually work out the next step. I find that patients often quickly open up and therefore the connection can be established very quickly. You really can help to make people feel better in one single interaction as a GP.
I love being involved in GP education and the opportunity it brings to shape the careers of others, and become involved in teaching, management, leadership and negotiation.
Being a GP also means living with uncertainty and balancing risks which can be a challenge. You’re guiding patients through an increasingly complex web of options and there are often economic considerations. You have to live with imperfection.
Life outside work
Maintaining a life outside medicine is really important. I became a parent later in life than many, and I’ve found I really enjoy my time with the children. Being a parent has also made me better able to negotiate, prioritise and delegate at work.
Singing has been an important part of my life since university days and I enjoy being a member of a local choir. It’s great to be in a situation where I’m not responsible for making decisions and to achieve high standards for pleasure.
I also practise mindfulness and yoga, which along with the singing help me to cope with the pressures of my job.
Career plans and top tips for others
I became head of a GP school relatively early in my career and I’m keeping an open mind about what might happen in the future. Whatever happens, I’ll always want to have contact with patients.
- grasp opportunities as they come along, but don’t worry about missed ones, as others will also come your way
- consider general practice as a career as it offers extraordinary variety and intellectual challenges
- once you become a GP it’s just the start of the journey - it takes time to learn the business side and it’s important to play to your strengths