Leonie Chamberlain: Empowering Registrars in the Business of General Practice

Mrs Leonie Chamberlain is an experienced CPA and practice manager from Melbourne's eastern suburbs, known across Australia as a passionate contributor to GP training - always keen to share her expertise with others through her role as Chief Operations Officer and Board Director for GPSA.

GPSA Communications Manager, Pauline Ingham, interviewed Leonie about GP training through her unique lens as the often-overlooked linchpin of the supervision team, the practice manager, and the first practice manager on the GPSA Board.

How did you arrive at your role with GPSA What do you think has brought you here?

"I think it traces back to being the third daughter and second youngest in a big family. With my two older sisters being four and six years older—and louder—than me, and my younger brother being the only boy, I had to speak up if I wanted to be heard. Growing up, I quickly learned that if I wanted to make an impact, I needed to be vocal, otherwise I’d get lost in the noise at the dinner table.

One of the guiding principles from my childhood, and one I have passed down to my own children, is that if you don’t like something, don’t just complain: be prepared to fix it.

"I’m a qualified accountant and started my career with one of the big six accounting firms. Blackburn Clinic was one of our clients. When the new taxation system came in around 2000, the Clinic saw a gap in their staff’s capacity, and I saw an opportunity. I wrote a proposal, and they offered me a job.

"My role at Blackburn Clinic is somewhat unique as we have a large practice. I serve as the Finance and Administration Manager, and the practice management duties are shared between myself and my colleague Helen, our Project and Development Officer. Helen manages the clinical side, while I focus on the non-clinical aspects.

"Through my work at Blackburn Clinic, I started attending practice manager workshops at our RTO. I realised that something was missing in the training registrars were receiving—they weren’t being prepared to be businesspeople. I raised this concern, and the RTO response was positive, which led to me getting involved in registrar education. From there, I moved into practice manager education as well.
Some time later, when GPSA was looking for a practice manager for their board, Dr. Gerard Connors, then a Board Director, put my name forward for an appointed position. At the time, it was a really difficult moment in my personal life—our daughter was in a mental health care facility. I told my husband it wasn’t a good time, but he reminded me that there’s never a perfect time to do things. If you wait for the perfect moment, you’ll never do anything. With his blessing, and our daughter’s, I took the plunge—and here I am."

How have your various roles prepared you for your work as a Director?

"My accounting experience and background were key factors for GPSA when evaluating the skills required on the Board. At the time I joined, the majority of the Board members were GPs, and few had formal commercial training. My accounting expertise filled a gap in the Board's skills matrix, offering a valuable perspective.

As a practice manager, each day presents new challenges. Flexibility is crucial, as no two days are alike. You must be prepared to shift focus, take on different responsibilities, and adapt to changing circumstances. Practice managers are facilitators. While we may not have all the answers, our role is to guide the process and help find solutions.

"At GPSA board meetings, a word we often use is "nimble." GPSA prides itself on being a nimble organisation—we act quickly and efficiently, no matter what comes our way. I believe my experience at Blackburn Clinic has been instrumental in helping me develop this adaptability."

You are the first practice manager elected to the GPSA Board. What has the practice manager perspective brought to that table? 

"One major challenge is recognizing the value of supervisors. High-quality supervision leads to high-quality doctors, which benefits the entire healthcare system.

Good supervisors help develop better doctors, who provide efficient care with fewer unnecessary investigations and referrals, ultimately saving costs and improving patient outcomes.

"Diversity of experience, knowledge, and opinion is crucial on any Board, and GPSA is no exception. My way of thinking often differs from that of other Board members, which means I frequently find myself playing devil’s advocate or offering alternative perspectives. Having a practice manager on the Board brings an essential layer of practicality to discussions, particularly when it comes to ambitious, ‘blue sky’ ideas.

"Big ideas are exciting, but they only become valuable when they can be implemented effectively. My role is to ground these ideas, analysing what they mean for those who have to execute them day-to-day. Policy and implementation must go hand in hand. When we’re considering decisions at GPSA and how they translate into practice, the perspective of a practice manager is invaluable. Supervisors handle one side of the equation, but practice managers are on the other side, managing the realities on the ground. Understanding how policies impact those responsible for daily operations is critical for ensuring success."

What are you passionate about in your role as a practice manager?

Teaching registrars about the business side of being a GP is essential, yet this aspect is often overlooked. 

"Most doctors will, at some point in their careers, work for themselves or at least need a solid understanding of what that entails. Whether they're assisting in surgery or doing locum work, they'll need to raise invoices, understand GST, and grasp the tax implications of their work. These are critical skills, but they aren’t part of the formal curriculum. I feel privileged to share my knowledge and help guide registrars in this area. I strongly believe this business acumen should either be integrated into the GP Colleges’ curriculum or taught during medical school. It’s a vital skill set that will benefit them throughout their careers."

What does GPSA offer our practice manager members, and why should practice managers join GPSA?

"One thing that sets practice managers apart is the nature of our role—we often work in isolation. While a practice may have multiple receptionists, nurses, and GPs, the practice manager is usually on their own. This is where GPSA becomes invaluable, offering a community where practice managers can connect with others who ‘speak their language’.

The GPSA Community provides a space to lean on peers, share knowledge, and support each other, especially when there’s no one else in the practice to bounce ideas off. This sense of community for practice managers is a wonderful initiative.

"Having worked solely in a metropolitan setting, I don’t always understand the unique challenges of rural practices, such as the level of interaction with the hospital, differences in item numbers or difficulties in attracting and retaining workforce. But with GPSA, I can reach out to the broader community for help—ask for input, share ideas, and tap into collective experience. Our members are increasingly realise the value of the practice manager group, and it’s making a real difference."

How can practice managers get the most out of GPSA?

"By engaging with one another and asking questions. Share your knowledge. Former GPSA Chair Nicole Higgins once shared a phrase with me that I’ve held onto ever since: “Steal shamelessly, share generously.” It’s a brilliant philosophy. Don’t cling too tightly to what you know—share it freely, and don’t hesitate to borrow ideas from others. We don’t need to reinvent the wheel every time. This mindset fosters collaboration and helps everyone thrive. So, steal shamelessly and share generously."

What challenges are presently of greatest concern in the realm of supervision for our members?

"There seems to be a growing ‘raising of the bar’ in terms of expectations from everyone involved in medical education, and this creates significant challenges. Supervisors face increasing demands, practice managers must stay on top of frequent changes, and registrars have their own expectations and needs.

"A particular concern is the amount of unpaid work supervisors are expected to take on as part of their role. It’s disheartening that when doctors raise this, they are often perceived as greedy, due to the widespread misconception that all doctors are wealthy. However, I’m not aware of any other industry that expects its professionals to perform as much unpaid work as GP supervisors do. Supervisors are paid for the teaching component of their role—around 3 hours per week—but much of the additional supervision, mentorship, and support they provide is voluntary. It’s unreasonable to expect professionals to offer their expertise and mentorship for free, yet that is what’s often required of supervisors. Whenever this issue is raised, it’s treated almost as taboo.

"This is particularly concerning as the population ages and older supervisors, who once saw this work as altruistic and part of their professional duty, are retiring. The newer generation of supervisors may not be as willing to work for free, and are less likely to have the benefit of workforce since they’re largely non-owner supervisors. Societal views on work-life balance and professional expectations have shifted, but this simply has not translated to adequate funding for supervision at the coalface."

Insufficient recognition and reward of supervisors and training practices is not just a challenge for our members—it’s a challenge for society. Who will train the next generation of doctors given the current model, where supervisors provide the bulk of education out of goodwill, is fast becoming unsustainable? This issue affects everyone: the medical community, government, and community at large.

What would you like to say to Australia's supervision teams?

"First, I want to express my gratitude to the practice managers and supervisors who voted for me in the last election. Thank you for placing your trust in me. I am honoured to represent practice managers on the GPSA Board, and I take this responsibility very seriously.

"I also want to extend my thanks to everyone involved in supervision teams. The work you do is nothing short of remarkable. When you take on a GPT1 or CGT1 straight out of hospital training, someone who has never worked independently in a consultation room, you guide them through a steep learning curve. They not only have to learn a new medical discipline, but also learn how to bill, call the next patient, and navigate new software systems. Within a couple of years, these trainees become incredible, independent practitioners—still learning, as we all do throughout our careers—but capable of delivering high quality primary health care. The role of supervision teams in this transformation is invaluable."

I deeply appreciate the fact that I still have a community GP to look after me, and I believe this is vital for everyone. While the long-term family doctor relationships that my parents had—where their GP delivered me and was part of our lives for decades—are less common now, I still cherish the connection I have with my own GP. Everyone deserves that continuity of care: a community GP who not only knows your medical history but also understands your social context. Without that, health care risks becoming purely transactional, where patients are seen as just ‘conditions.’ A true GP relationship is more than that; it's about knowing the whole person.