Pin Pods: Wendy Harris, Cambridge Medical Centre owner and business manager

When business managers and practice managers are pressed about their interest in ownership, often the response is along the lines of “I can't because I'm not a GP” or “I don't think the GPs would even entertain the idea”. 

In this chat with Wendy Harris (podcast audio), non-GP owner and business manager of Cambridge Medical Centre in the Waikato, Helen and Wendy talk about how Wendy came into general practice four years ago, why she decided to move from being the practice’s business manager to also one of its owners, and what that experience has been like for her.  

Wendy started her working-life in youth work in Dunedin, working with the Salvation Army. In moving to Auckland she took on a community support worker role with the mental health service, working with adults. She started a family, and this was her opportunity to start her own business, offering policy and procedure development to small and medium sized enterprises. An opportunity arose to take a role as a business tutor at Te Wānanga o Aotearoa in Hamilton, teaching business studies. Through a contact there she landed a role as a HR consultant and via that she came to know Cambridge Medical Centre, who were a client at the time. 

Wendy is now in her fourth year working at Cambridge Medical Centre, making her relatively new to primary care. Experiencing general practice as a patient who then became employed in general practice and saw things from the other side, left her surprised at “pretty much everything”. She approached the business manager role thinking she had a pretty good understanding of business, and the confidence that she’d worked with Cambridge Medical Centre in her consultancy role.  

“But when you’re actually in there it’s quite a different story and the biggest thing was all of the terminology. I sat in many a meeting not knowing what on earth was going on!”  

Politics was also a learning curve, particularly in terms of where general practice fits, “and it’s ever-changing". 

One of the biggest ways Wendy sought support with the change curve was meeting with other local practice and business managers. She notes that at the time there were a number of new practice managers, so they set up a support group to help each other and share ideas.  

Helen notes that speaking to new practice staff who’ve come in – particularly from a different business ‘world’ – they understand and are relatively comfortable with the business and managing staff – but being at the patient interface is generally new to them.  

Wendy found her experience in dealing with challenging behaviour and her HR background helped in the process of finding solutions. “It’s never as bad as it first seems and there’s always a way of figuring it out and keeping all parties happy, for the most part,” she says. 

With consideration to the increased demands of data coming into practices and complex financial flows, Helen reflects on the move she’s seen from traditional practice management roles to practices creating a more formal business manager role, responsible for managing the business as opposed to staff and reception.  

When asked how she sees the role of business manager developing for practices, Wendy notes the reason she came into it was because “GPs traditionally did everything – they saw the patients, they managed the practice, they managed their own finances, and they don't want to do that…it makes sense to bring in a business/practice manager to do that.”  

Wendy feels fortunate that her management team and directors have allowed her to do it all. “That ‘here, it's your job, you run everything anything, you manage everything.’ But it does mean you have to be very rounded in terms of your knowledge and skill base,” she says.  

Wendy notes some of the skills needed when moving into the business manager role include strong financial skills and understanding, HR – because a lot of time is spent managing people whether patients or staff, and building a strong team – contractual understanding and legal terminology, a good understanding of the health industry in general and the ability to keep on top of the constant changes and what they mean for your practice and patients. 

Helen observes there’s often a difference, in terms of how informed and supported practice managers feel, between those that network a lot and those that are more isolated. However, there is also a competitive nature with general practice where there can be a bit of a tension.   

Wendy thinks the overall goal of general practice generally takes precedence. “At the end of the day, we're all there for the same thing, to provide really good health care for our patients. Although you’re competing with other practices, patients have the choice to go where they want to go. So you just have to do what you do, really well,” she says.  

Wendy has been an owner of Cambridge Medical Centre for a year. The founding GP was looking to retire, so the other directors were looking at a succession plan. They asked Wendy if she’d consider buying into it. “I really enjoy working here so it made sense to consider it,” she says. 

There were two major parts to Wendy’s decision to become an owner. It needed to be a good investment – “if I was contributing financially, I needed to make sure it was a solid investment for me...” The other part of it was around values where she had to consider issues such as ‘do the other owners share the same values and goals as me? Where do I see this practice going and do I think I can achieve what I want with the practice, as an owner?’ 

A year on, Wendy’s role hasn’t changed, and her relationship with the management team hasn’t changed, but she feels much more invested.  

“When I decided to become an owner, it wasn’t for the short term, it’s potentially for the next 20 years…the rest of my working life.” 

Helen comments that for some GPs, they note the longevity of GPs in practice and practice ownership, and the benefit of that stability for the practice and its patients. They see concerns in widening up ownership to nurses or practice managers because there’s potential they won’t consider ownership being long-term. This was a consideration for Wendy, and she acknowledges the risk but also the importance of a balance of scope. 

Helen comments that, particularly for those with young families, there’s a perception that as an owner it’s assumed people have to work longer hours, and work weekends and evenings, as opposed to just salary contracted hours.  

Wendy confirms this isn’t the set up at Cambridge Medical Centre and that they changed the structure and created the business manager role, in order to prevent that. Wendy notes there will “always be an element of owners having to do a little bit more work because it’s your business” but says a robust model of management and structure can minimise the extra work. Though she’s quick to agree it’s dependent on practice structure. 

With the health and disability system review coming up, Wendy’s hopes for the future are that the value is seen in general practice remaining privately owned, rather than being swallowed up into a DHB model. And that the individuality of practice isn’t lost. 

“I also hope there’s still a voice for general practice, whether that’s a PHO like it is now with Pinnacle or something similar, I wouldn’t like to think we have to negotiate directly with DHBs, I don’t think that will work.” 

She strongly believes frontline healthcare is really where is should be.  

“GPs are very skilled...and we could do a whole heap more in general practice if we just had the funding to do so.”