GP Lives: Making the switch

A focus on standards, a commitment to avoiding overdiagnosis and overtreatment, and ensuring an exceptional patient experience are the cornerstones of Dr Heather Ryan’s private GP practice.

Heather and her husband John – both formerly GP partners - set up Formby GP in Merseyside in January 2023. Post-covid, with two young children, they wanted a change of pace, so decided to leave their partnerships and go it alone, identifying a gap in the market for private primary care in the ‘traditional family doctor’ mould.

“A lot of private practice provision seems to target healthy young people with things like screenings, IV vitamin drips, aesthetics, and often unnecessary tests and treatments,” says Heather. “We wanted more autonomy, and to be able to offer good, evidence-based care, unhurried appointments, and to only arrange tests and treatments when clinically indicated.”

The patient population at Formby GP is diverse, although predominantly over 40, and most come to the practice with clear health needs.

“We were worried we’d be inundated by young people wanting antibiotics for a sore throat, but we see people who are genuinely unwell, and have picked up serious conditions including cancers, heart failure and neurological problems,” says Heather. “It’s so rewarding to pick up these pathologies and feel like we’re able to make a difference to our patients.”

Heather and John offer four 30-minute appointments a day, increasing that number to meet demand where necessary.

For Heather the key difference between working in NHS and private practice is being able to provide more continuity of care.

“What I love is that we’re able to do the things that give GPs the most pleasure – getting to know patients and building relationships, having time to do a good history and consultation, and having proper continuity of care. Our patients know us and trust us.”

Although early days, the practice is doing well, but Heather is clear that private practice is not a fast way of making money.

“Private general practice is a growing sector and there’s scope for growth, but it’s not a path to riches. When we started, other private doctors told us that it can take three to five years to make a profit. A year on, we’re just in profit, but it’s been challenging. In the short term, we’d definitely be better off financially if we’d stayed in the NHS.”

The trade-off, she says, is the better work-life balance she and John are now able to enjoy. With two children under five, the flexibility from running their own practice  has been a game-changer. “We do private clinics in the morning, and if we have home visit requests or admin to do we fit those around our bookings and other commitments. The reality of owning our own business, as a married couple, does mean that we sometimes spend evenings and weekends discussing the practice, but overall it feels like we have a sustainable balance.”

As well as her private work, for the past three years Heather has worked two days a week as a GP in a medium secure mental health unit. “Mental health patients have been underserved in terms of physical care, and I’ve been interested in that since being a trainee,” she says. “When I saw the position advertised, I couldn’t wait to apply, because it was my dream job! It also allows me to work as part of a team with a variety of healthcare professionals, which I really enjoy.”

A self-described “representative of the grassroots GP voice,” Heather is passionate about making sure ordinary GP voices are heard and has been involved with the College since being a trainee GP, first as AiT rep and then as a Recruitment Fellow, Deputy Council Rep for Mersey Faculty, and now interim vice-chair of Mersey, which she credits as being instrumental in her career development.

“The faculty board is small and it’s like a family – it’s been a defining element underpinning my career. The more experienced GPs have had a huge influence on my approach to medicine.”

Last November Heather was elected to College Council and has a clear agenda for what she wants to achieve during her term.

“It’s wonderful to be in the room where the decisions are made,” she says. “I’ve been pleasantly surprised by how much influence I have. The officer team really does listen.

“My passion and focus is standards in private primary care. A lot of GPs work privately, and given that RCGP represents all GPs, we need to ensure the College is the professional home for these doctors. We should embrace them and make sure the same standards of evidence-based care are applied in private as well as NHS care.”