“I want general practice to flourish and if I can help that in a very small way, I will feel satisfied."

Dr Tim Chappell is a Perth-based GP, practice owner, supervisor of medical students and vocational trainees, Supervisor Liaison Officer (SLO) with the RACGP, and co-Chair of the national SLO Advisory Council. Tim's passion for education has motivated him throughout his career, and, in the context of general practice training, that passion is infectious: as anyone who attended his 2-part webinar series with GPSA can attest!

GPSA's Communication Manager, Pauline Ingham, spoke to Tim on the eve of the historical meeting of the SLO and RLO Advisory Councils in Brisbane this weekend.

How do you maintain your level of passion for supervision?

I guess I have a passion for teaching, which is probably inbuilt in me. I am fascinated by the nature of general practice, how rewarding it can be, and the enjoyment of practicing as a doctor.

“I want registrars to understand the role of medicine so we have future doctors with a really good grasp of what it is to be a general practitioner.

"In my view, the GP role is being slowly eroded and being in danger of being lost. So much of  training in medicine, in general practice, is much more akin to apprenticeship than it is to learning from books, though the latter certianly has a role. A doctor needs to have an understanding of what it is to care for someone, to have attention to detail and to understand the philosophy of general practice. These things are important to me and they fuel a lot of my passion.

“Early in my career, I was inspired by Dr Ian McWhinney’s book on general practice. A Canadian GP, he wrote extensively about general practice and what it meant to be a family physician. He articulated many aspects that resonated with me and helped me really understand my role as a doctor and that it’s so much more than just knowing facts.”

What drives you as a practice owner?

“I was fortunate when I walked into this practice many years ago, I thought this is exactly the sort of practice I'm looking for. It’s a place of high professionalism with a good reputation which offers high quality practice of medicine. That is paramount. But it’s also a really fun place to work and a very supportive place to work. Importantly, doctors are given a lot of freedom to do things and there is time for patients but there is also time for education and time to do home visits. So, there's a lot of what I call ‘grace’ in the practice. Later, when I became a partner, I saw a great opportunity to build on what had already started.

Allowing doctors to show initiative, and not be dictated to, gives them a sense of being.

“I’ve learned as a Director the role of the business owners is to set the tone and to actually encourage good medicine and to allow that to come about, to be almost like a cheerleader for good medicine. Whether I do that, I'll have to let the other doctors decide."

What impact does having the right business structure have on your ability to give your all as a GP and supervisor?

“Having the right structure allows everyone to play their role in the practice. Having the right people is key. In our practice there are four directors, a practice manager and my wife, Vanessa, is the Finance Officer. Payroll for registrars has an extra layer of complexity that few understand - including myself. I'm sure we could have registrars without Vanessa managing the Thesian maze that is the payments and administratve requirements for registrars but it would be a small miracle. As that that side is all taken care of, the rest of us don't need to worry about that, freeing us up to, as you say, give our all as GPs and supervisors!”

So you are in a leadership role as co-Chair of the SLO Advisory Council... What drives you as an SLO? What's your motivation?

“When I saw the job advertisement, I thought, 'that's something I can do'! I am genuinely interested in people, I like people. Maybe I should add that includes my colleagues. I love looking at other practices as it really intrigues me how other people go about teaching and how they set up their practices.

I genuinely want to see good, high quality teaching. I want general practice to flourish and if I can help that in a very small way, I will feel satisfied. 

“The SLOs are employed by the Colleges, in my case the RACGP. I was interested to find out how they worked from the inside and be an intermediary with supervisors. It's been an education.

“When I started the role to represent supervisors in my region, I decided I’d better get to know my constituency. So I undertook to visit all the training practices in WA. I didn't get to all of them but managed to visit 106 supervisors throughout WA.

"It was a surprisingly rewarding thing to do and I would encourage every SLO to do it if they can. It gave me the opportunity to talk peer to peer and discuss issues on the ground. I think it helped being a practice owner and a supervisor of sixteen years. I understood the deeper issues and burning questions they faced, as well as how certain factors could significantly impact the business of a practice. Their problems were my problems. As such, I found that people generally made time for me. If you happen to be one of those supervisors reading this then 'thank you' for your welcome.

“Connections with the supervisors I met are slowly growing, these things take time. I’m very pleased I was able to get to know people, listen to them, build relationships and feel comfortable about representing them."

Do you find supervising medical students equally rewarding as registrars?

“Medical students and registrars are very different in terms of responsibility and approach. Students have no responsibility, while registrars bear full responsibility. 

"With students, you can quickly develop rapport and friendship, especially when they are with you for extended periods. Although current students spend less time with supervisors, connections can still be made.

Registrars bring energy, enthusiasm, and new knowledge to the practice, keeping us updated and sharp. Their questions and fresh perspectives prevent us from becoming jaded.

“Registrars contribute significantly to the practice, both in terms of knowledge and community. The thought of losing the opportunity to have registrars would be devastating. Some registrars start by feeling overwhelmed but most quickly find their feet and start making critical decisions independently. This transition from hospital to general practice is challenging but rewarding.

"The supervisor-registrar relationship is akin to a master-apprentice dynamic, where the supervisor's experience guides the registrar, who brings fresh knowledge. This mutually beneficial relationship is crucial for effective supervision. It's essential for supervisors to have substantial experience before taking on this role, ensuring they can provide meaningful guidance and support."

 How do you envisage GPSA's role in ensuring that general practice training is fulfilling for everyone involved in the practice?

I'm so appreciative of GPSA for their work... there's not many people who speak up for the supervisors underpinning GP training.

"GPSA is so helpful as a voice for supervisors, and at a very basic level supporting practices through the national terms and conditions for registrar employment. The NTCER is a key resource when it comes to negotiating contracts and employment terms - just knowing there's a supportive body for supervision teams to turn to is actually very important.

"Their teaching and education has also been excellent; I've always really enjoyed the GPSA webinars. For me it's been a breath of fresh air because a lot of the teaching for supervisors has typically been very theoretical rather than at the grassroots level, but what GPSA offers is so much more practical.

"In terms of GPSA supporting everyone in our practice, I think it's getting there for our team. I feel like GPSA is still being discovered by a lot of people. So I keep trumpeting the webinars and the resources on offer. "

What challenges are presently of greatest concern to you in the realm of supervision?

My greatest concern is the ongoing erosion of general practice by people who don't seem to understand it.

"This 'death by a thousand cuts' results from numerous small policies that fail to consider the bigger picture. The government often responds to constituent demands with solutions that ultimately undermine the value of general practice.

“A productive response is to clarify the role of the GP. At the heart of general practice are the relationships that make this specialty so rewarding. The erosion occurs because many people underestimate the complexity and importance of these relationships, mistakenly believing the work of GPs is simpler than it is."