The Portfolio GP – Dr Kieran Sneath

This week we hear from Dr Kieran Sneath, a GP that loves the variety his portfolio career brings.

What does ‘portfolio GP’ mean to you?

I am just a GP that likes to keep a varied interest and do different things. I guess by convention, anyone who works outside the normal scheme of either being a partner or salaried GP is by nature a ‘portfolio GP’.

How do you divide your time?

In terms of my working week, I work as a freelance sessional GP in regular practices in North London and Hertfordshire. This includes your conventional family medical practice but also in a university medical centre as well, which is very interesting being involved in primary care of healthcare needs of university students.

On top of that, I work as a private GP doing home visits for GPDQ, I am a specialist advisor for the CQC doing inspections on healthcare organisations, and I do some work doing private medicals, for example, occupational health medicals for patients who want to become drivers or taxi drivers.

I also have an evolving interest in digital innovation within healthcare, which I am currently thinking about and have inroads and avenues I am pursuing. I have interests within GP as well, in particular musculoskeletal and sports medicine.

What made you go down the portfolio route?

I think for me it was quite serendipitous. I didn’t necessarily set out this way. I like variety in my work. I like to be in more control of my schedule and do different things. I also don’t like to be stuck in one particular place all the time. I suppose it was just by experience, opportunities, coincidence, network, and connecting with different people. Opportunities come up and I thought, I would like to do that. After a while, it moulds into a cohesive work plan and if you get it right, you can set it up so that you are doing regular work, but with variety.

Does a portfolio career support a good work-life balance?

Yes, I have a good work-life balance. I am able to do the school run in the morning. I am able to go home for lunch most days. I may want to take time off if I need to have an appointment or if it’s my children’s sports day. There are other people I know that just can’t do that. Obviously, a lot of my work is self-employed, but I think, as long as you manage your work and life appropriately and you budget for those times, it really works well. I don’t think I have ever had a better work-life balance.

Do you think having a diverse portfolio makes you a better doctor? And how does it affect the patient care you deliver?

Yes, for me definitely. I think firstly, variety is very important. I don’t think you gain experience by just seeing more patients. It is also about seeing different patients in different environments. For example, when I do a CQC visit, I can see that some things are done really well and I can take it back into my own practise.

Do you see portfolio careers as the future for general practice?

I wouldn’t want to state unequivocally that it is the future for all GPs. But I would certainly say that it would benefit a lot of GPs. Newly qualified GPs should not be scared to step outside of the conventional box and do other things as well. The traditional route of becoming a GP followed by doing a salaried role or partnership; those days are in decline. I do know GPs that are newly qualified and have gone straight into a partnership. They are very happy and I think that is for them. But I think for a lot of GPs now, they should consider other avenues as well, to complement the traditional approach.

What message or advice would you give other doctors about the portfolio route?

I think by adding different themes into one’s work, there is less chance of burning out, so that you are actually more refreshed. NHS clinics are really rewarding, and I really enjoy it. But they are quite intense and it requires a lot of concentration. If you are doing that all the time, it can really wear you down. But if you are doing something else, you are going to be a bit more refreshed. I think it refreshes and invigorates you and prevents burnout.

I think I have probably come close to it (burnout) at points, but I recognised when that was happening and took action to do different things. I think the danger is when people aren’t able recognise that they are burning out and just keep heading down. So many more mature GPs are retiring early and so many younger GPs are going abroad. The portfolio career may not be for everyone, but I certainly think that it will sustain a workforce to work harder, over a longer period, and ultimately be happier within the NHS as a result of doing other things as well.

If you could send a message to the NHS about portfolio GPs, what would it be?

With such recruitment and retention crises going on in the NHS, it’s crucial to make the NHS work more feasibly and be more attractive to people. I think that the NHS needs to realise GPs want to work flexibly. In order to prevent burnout and sustain a workforce in a really difficult and challenging environment, we need to be open about GPs being able to work outside the NHS, to keep them refreshed in both the health of the doctor and the benefit of the patients that they see as well.