Consider the following scenario…

Dr Finlay is the senior partner of the prosperous, well funded Lazy Acres Health Centre. it is situated close to a rundown housing estate in the otherwise very prosperous, and leafy London Borough of Southam. Dr Finlay has overseen the transformation of what started as a two-person GP practice that operated from cramped, substandard accommodation in 1980 to a seven partner operation with five additional assistance GPs and two nurses. Additionally the practice has an out of hours practice and accommodates some local NHS physiotherapy, counselling sessions, and has a blood testing facility. Dr Finlay and two of his partners also have impressive private patient portfolios.

Dr Finlay proudly refers to himself as being of the old school. He often waxes lyrical about his humble beginnings and is as proud of his school certificate and his parents having survived the combination of the 1930s depression, the blitz and post war rationing as he is of his considerable achievements as a doctor and businessmen.

Recognising that commercially speaking, Dr Finley has an excellent track record, until recently his partners tended to focus on their medical work and left him to do everything else. Partnership meetings were very brief affairs during which those attending would do little more than nod at the appropriate times.

Recently, the practice took on an eighth partner, Dr Sood, who is significantly younger than Dr Finley and the other partners. She enjoyed a privileged upbringing and is seen by many as a member of the liberal elite and her father and two uncles are all accomplished consultant paediatricians. There are those that consider that her Lazy Acres partnership is a stepping stone to greater things and that she has set her sights on becoming senior partner. She considers herself to be very progressive and unlike her older colleagues including Dr Finlay, she has warmly embraced new medical practices. Dr Sood considers that Dr Finley’s frequent lectures about saving costs and not making unnecessary hospital referrals are outdated and unprofessional.

Partnership meetings are not what they were. Dr Sood asks questions, wants to discuss things in detail and considers that proposals should be voted on. She questions a lot of the time honoured practices that her colleagues adhere to and on occasion speaks her mind. She attaches great importance to the implementation of good working practices and shows the support staff and nurses a level of consideration that they were not previously used to. Some of these staff remain steadfastly loyal to Dr Findley but others begin to criticise his autocratic manner. There are some heated disagreements about staff salaries and morale declines.

Dr Finlay who now regrets having taken on Dr Sood as a partner does not welcome her input. He realises that removing her would cost a great deal of money and instead, to counter what he has described as her “pernicious influence”, adopts a strategy of being argumentative and finding fault. Dr Sood responds in kind and unfortunately, on a number of occasions  there are rows in the  waiting room in full view of patients. One or two of the private patients ask Dr Finley “if everything is all right”.

As ostensibly loyal to Dr Finlay as they have been, the other partners realise that things cannot go on. The quality of the supporting staff’s work has declined and the discord between Dr Finlay and Dr Sood weighs heavily on their minds. Litigation is considered to be out of the question and other alternatives are considered.

One option would be to call in the local GP committee who could liaise and try and negotiate with Dr Finlay and Dr Sood. However, Dr Finlay in particular is very wary of this. There is no suggestion that anyone in his practice has broken the law or failed to follow any medical guidelines and he is concerned that he does not want any “interference from outsiders”. Also, his perception is that the GP committee that operates in his area is not truly independent.

Accordingly, Dr Finlay and Dr Sood agree to instruct a mediator. The mediation takes place on a Sunday when the practice is closed and  very few people know that it is due to take place. With the benefit of them being able to listen to one another in the safe, confidential environment that their mediator, Martin, provides, Dr Finlay comes to realise that his recently acquired partner is a highly skilled and well motivated medical practitioner who is not a profligate troublemaker.

Equally, Dr Sood realises that her senior partner has a sound medical brain and also a commercial acumen that she lacks. She raises the subject of the “time honoured medical practices” and  she is able to demonstrate that they are not only ineffective but also not cost effective, Martin is able to identify some significant common ground. He encourages the two doctors to discuss this at length and the net effect is that an informal but nonetheless genuine accord is reached. Dr Finlay agrees to review staff procedures and practices and much to Dr Sood’s surprise accepts that it would be beneficial for someone to undertake a complete review of the Lazy Acres working practices.

Martin then specifically suggests that that one of his colleagues who specialises in such matters and will take appropriate medical guidance, undertakes a review, a neutral evaluation, a suggestion that Dr. Finlay accedes to.

Martin’s reassurances about confidentiality and his complete impartiality have impressed Dr Finlay greatly. He also recognises that the combined cost of engaging Martin and his colleague is a fraction of what it might otherwise have been.  Lazy Acres looks forward to a happy and successful 2017.