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Doctors at Work Podcast.

Episode #84

How to have a portfolio career. With Ellen Welch

Mat Daniel

03/05/2024

Ellen Welch is a GP and a book author, and has had a variety of different roles in the past. In this episode we discuss portfolio careers. She outlines how she has reinvented herself multiple times, based on what she wanted and on how work fitted into the rest of her life. She outlines how being flexible is a real asset, even if flexible careers have both up and downsides. Making decent income from portfolio careers might not be easy, but as doctors we should always remember the value that we bring and the skills that we have. I love her can-do mindset, instead of moping about what is wrong, she has repeatedly gone out and made her desired future happen based on what she wants.

Ellen is an NHS GP and writer based in Cumbria. With 20 years clinical experience, she has pursued a variety of portfolio roles worldwide, including stints as a a ski field doctor in New Zealand, an expedition medic in Tanzania and a Cruise Ship Doctor and repatriation doctor around the world. She holds a BA in medical journalism and has pursued her interest in writing alongside her clinical career. She has written  several books and has been published widely in both trade and National press. She has also appeared on TV and Radio in her previous role as co-chair for the Doctors’ Association UK. Her latest book “Why Can’t I See My GP: the past, present and future of General Practice” was released in February 2024. Find out more about her at https://linktr.ee/DrEllenWelch

You might also like Episode 81 on how to define career success, 77 on a career in General Practice, 66 on making career decisions, and 65 on portfolio careers.

Watch at www.youtube.com/@dr-coach/videos.
Production: Shot by Polachek

Podcast Transcript

Mat: [00:00:00] Welcome to Doctors at Work. My name is Mat Daniel and this podcast is about doctors careers. It’s part of my mission to help other people create successful and meaningful careers. Today’s podcast is about portfolio careers. My guest Ellen is a GP and a book author and she has had a variety of different roles in the past.

She outlines how she has reinvented herself multiple times based on what she wanted and on how work fitted into the rest of her life. She outlines how being flexible is a real asset when it comes to careers, even if flexible careers themselves have both up and downsides. Making decent income from portfolio careers might not be easy, at least to start off with, but as doctors, we should always remember the value that we bring and the skills that we have.

I love her can do mindset. Instead of moping about what’s wrong, she has repeatedly gone out and made her desired future happen based on what she wants.[00:01:00]

Welcome, Ellen. Tell me a little bit about yourself. Well,

Ellen: for having me. So I’m a GP. Um, I’ve now been a doctor for 20 years, um, a GP for 10, and I’ve got what would be described as a portfolio career. So essentially a little bit of this, a little bit of that. Um, yeah, to give me a bit of background, so I’ve done quite a lot of different things in my career.

So I started off, um, I did house jobs when we were still called house officers. That was the time when we still had hospital accommodation and um, a bit of a nicer conditions than juniors have these days. After my first year as a doctor, I went abroad to New Zealand. I worked over there for a little while.

And, um, initially at that point, I wanted to do, um, tropical diseases, infectious diseases. So I came back to Liverpool, which is where I trained and did the diploma in tropical medicine and hygiene. And then from there, modernizing medical careers came in. I’m not sure if you remember that or if you were around when [00:02:00] that came in.

But we were, um, yeah, basically sent far and wide. So I ended up doing A& E training. I started doing that in Leeds, um, yeah, when I was, sorry, I feel like I’m rambling. When I was in New Zealand, I had some experience working in a e and I loved it and came back and, and started training in a e in the uk. So I did that.

I did my a e exams, I worked in, in the Leeds area for quite a few years, and then got a little bit burnt out with a e and saw an advert in the BMJ to work on cruise ships. So I applied, I need a little bit more experience. So I got that experience, finished my exams. And then after about five years, post post grad, I, I went to work on cruise ships as a cruise ship doctor, uh, which was great.

Um, I did that on and off for 10 years. So, uh, contracts on ships are usually about six months. Six months on, um, three months off. I think now they’re four months [00:03:00] on, two months off, but my first contract was six months. Um, so I did a few contracts where I’d work Work at sea and then come back to the UK, UK.

Um, and it was actually when I was on cruise ships that I, I was a GP to the crew. So in some countries you were GP without doing the exams that we’re doing in this country. So a lot of my colleagues were essentially, I like, I like doing the general practice on ships. So I went back to the UK to retrain as a GP and a lot of my colleagues on ships were quite surprised I was doing that because, you In, in their countries.

You’re a GP as soon as you, you leave medical school. Um, so yeah, I, I came back and trained as a GP in the UK and then would go back and forth and do a few short contracts or go on my holidays to cover ships, um, while I was training to be a gp. What’s a variety? Yep. So since then, so over the 10 year I came back to the uk I, sorry, I, I did quite a few years.

of pretty much [00:04:00] pure cruise ship medicine. I worked as a GP in London once I was qualified, so it went between London, ships, London, ships. And then I Basically came back to settle down and start a family in 2018. So since then I was an out of hours GP. I had my kids and I’ve been doing remote GP work since having my kids and that’s what I continue to do today.

And you’re

Mat: a book author

Ellen: as well? Oh, yes, so I’m a writer as well. Tell

Mat: me about your

Ellen: books. So that’s something which started again in medical school. So, medical students can intercalate and do a science degree, but there was a degree at that point where we could do medical journalism, and I think it was the University of Westminster, they don’t do it anymore.

It was a year doing a purely arts degree, so I spent a year doing medical journalism, and a lot of my writing started from there. Um, so my first book, it was something that [00:05:00] was, I wrote an article in a magazine I did work experience with at the time, and they asked me to develop that into a book, so it was a very dry subject.

Being a thromboembolism, I wrote a book on that, and then since then there’s various projects came up, often quite fortuitously, it’s something I was often approached by other people to write them. Um, and my current book, it’s called Why Can’t I Say My GP, that came about a lot of the work I was doing with the Doctors Association UK, so an organisation I’ve been involved with for a few years, and speaking up for GPs, talking about what’s going on in general practice.

Um,

Mat: And I think the topic for us today then is portfolio careers and um, maybe, maybe what is a portfolio career?

Ellen: I think it describes someone who just doesn’t do one job and does lots of different jobs and, and varies what they do within their, within their career. working week. Um, [00:06:00] so for me, I, I mainly do my remote GP local work, but then I do writing, which isn’t always paid.

That’s often stuff I do a bit voluntarily in my free time. Um, at the minute, that’s all I do. But I guess in the, in the past, I’ve done a bit of the cruise ship work, a bit of the GP work. I used to do remote retrieval work where you go abroad, bring people back from overseas. Um, out of hours, GPS work, doing a little bit of everything is essentially what, what a portfolio.

Career is and I guess the benefit of it is you you’re fresh for all your jobs So if you’re doing it nine sessions of general practice at the minute, it’s quite brutal and it’s quite Exhausting just having a relentless barrage of patients problems for nine sessions a week. I think that’s unsustainable but Doing the portfolio work just gives you a bit of a bit of a break for that and lets you pursue other interests and do other things.

And I think it’s a good way to retain people within the NHS to let them not do full time GP [00:07:00] and do other things so that they’re not completely burnt out.

Mat: And I’m wondering how you got started in this because if I think when I finished medical school or the people that I talk to Is, you know, they say, well, you know, I’m either gonna do medicine, surgery, you know, psychiatry, obs and guy your pediatrics, you know, or, or a version of those things, isn’t it?

Yeah. And that’s it. And there’s a, there’s a conveyor belt and you know, and, and, and there’s a royal college that, that powers it and you step onto that conveyor belt and then definitely. And then sort of, then you come off sort of, you know, the, the other end of the conveyor belt, you know, sort of what, what, whatever you do, and, and you know, whether that’s.

sort of general practice college or emergency medicine college, you know, or, or, you know, ENT UK sort of, you know, my society like, um, but, you know, how did you, did you know that sort of, this is something you were interested in or how?

Ellen: No, not at all. I think I didn’t know what I wanted to do and that was probably why I fell into this sort of work, but I knew very much I didn’t want to get onto the conveyor belt.

And I [00:08:00] think your career is long. I was in no rush to qualify as anything quickly and then spend the rest of my life. in one job forever. Um, and I think probably my experience early on in my career in New Zealand opened my mind a little bit because in New Zealand it’s very common for people to do other stuff, to go traveling and to finish their house jobs and to, to go traveling and do something unrelated to medicine, just have a year out.

And lots of the consultants there encouraged that and they didn’t frown upon it in the same way as perhaps our consultants in the UK would have done at that stage of our careers. Um, Because you’re right, the conveyor belt is such a fixed mindset in the UK, but I think moving somewhere else and seeing how it’s done differently elsewhere does make you think we can’t do it this way.

It’s, it’s not essential to, to follow, to follow the, the strict path that we’ve got in the UK. And I think I knew I wanted to travel and use medicine to travel and, and I have been able to do that with the cruise ship work and the retrieval work. And I think that’s [00:09:00] important, just thinking about what you want to do with your life and use your career to help you do it.

Mat: It’s interesting if I think for me and I’m, I’m older than you predating MMC, um, but if remember when, when, when I was maybe finishing, I don’t think any of us knew what we wanted to do. And as you said, people were encouraged to go and find themselves. Yeah. Yeah. And, you know, and normally sort of when. In my cohort, that meant you did six months of A& E and six months of traveling, you know, or a version of that, and everybody went to Australasia, sort of, you know, for not, not to stay, but you know, for six months or a year, something like that.

And then, you know, and then most people probably still didn’t know. And if I think, you know, You know, I wasn’t quite sure, but I thought for me, maybe surgery is for me, but I thought I’ll do basic surgical training. It’s three years. I’ve got three, I’ve got, you know, really two and a half years before I have to decide.

And at the end of that, then you became a senior SHO, which then was another year or so. So, you know, you did your two and a half years and two and a half years later, you [00:10:00] then decided which senior SHO jobs you’re going to get. And then you spend another year or something as a senior SHO, and then you applied for registrar.

You know, that’s kind of the way the ENT works. It was, and that experience was considered valuable, you know, if I think for me, you know, I did lots of general surgery. I did, I did HDU stuff. So, you know, by the time I became an ENT registrar, I, I knew at least the kind of the basic level HDU care inside out.

And I could really, I really knew how to look after critically ill patients. Um, and the kind of the, the, what I see now when I talk to students or F1s, F2s, it’s like people say, oh, I must get on, I must jump on, the world is going to end if I, if I don’t get. And I think there’s probably a bit of a backlash because so many people are now doing F3, F4, you know, and all that, but there’s just a

Ellen: culture change.

No, sorry, I was taking trouble. But yeah, I agree. I think they’re doing F3s to try and recreate what, what it was like, what you described, because it is important to get that experience. It makes you a better doctor, I think.

Mat: And how did you know [00:11:00] that you want, you said you, you knew that you wanted to travel.

So I guess, how did you know that you wanted to travel?

Ellen: Well, it’s what I enjoy. I like, I like, To travel, I like to go to different countries, see how things work in different, different places. Um, and maybe it was a bit of a disillusionment, disillusionment with the NHS and the thing, the way things are, and hearing stories from overseas.

And I think when you, you do go and see it elsewhere, it, there are better ways of doing certain things, and there are different ways of doing things. And I think we’re brought up thinking the NHS is the best system in the world, but actually it’s not. It used to be great. It used to be, there’s lots of things that are, Good about it, but there’s lots of things that have that work better elsewhere.

Mat: It’s interesting when I went to Australia, I thought I was going to hate the Australian healthcare system. Actually, I thought, you know, it’s all right.

Ellen: I think paying for care is something that is so alien to us coming from the NHS, and that working on cruise ships people had to pay to see me and actually [00:12:00] exchange money and that was quite a culture shock.

Um, And, and yeah, but it did make me value what we do and, and everything was itemized or everything you do down to the, maybe it’s the, the role of tissue paper that the patient lies on. Everything has to be charged and it makes you think about what we do in the NHS every day that we don’t think about that side of things.

And it, it did make me think about things in a different way.

Mat: And and maybe we might be able to save some money, you know, if you and I knew how much a roll of tissue paper cost You know, we might be we might be a bit more careful

Ellen: with this That was another thing they did in new zealand when you requested results It was still the paper forms But they had the the cost of the test when you tick the box you could see how much each test cost And I thought that was quite good to make you think about

Mat: it Okay, um, I I guess you know in terms of the traveling you you knew that you enjoyed traveling So in terms of i’m thinking for other people’s Career decision making.

It’s important to know what it is that you understand. Yeah. And that means, that means spending some time reflecting, getting to know [00:13:00] yourself, you know, understanding what your interests and what your drives and motivations are, because you knew yours was traveling for other people to be something else.

Yeah. But, but that, that, that means somebody pausing, taking a step back, spending some time getting to know themselves and say, this is what I want in my life. And then that’s one of the things that then guides career decision

Ellen: making. Sure. Yeah. Yeah, I’d agree with that, for sure.

Mat: I’ve got to ask though, traveling, that must have been lonely.

Ellen: Well, um, no, I went with my friends. The first one I went to New Zealand, there was actually quite a few of us who ended up going from New Zealand, um, from, from our medical school in Liverpool. So I actually had some friends there, but I don’t think it is that lonely, because whenever you join a cruise ship, it’s quite lonely.

For example, I did that by myself. You’ve got a ready made family there as the medical team, so you’re working with these people day in, day out, and you get quite close. And I guess the calming moments of being lonely and a long contract and missing friends and family, but You are busy [00:14:00] and you’ve got a ready made team and almost a ready made set of friends in the medical team.

Mat: And how do you integrate that kind of, that kind of lifestyle with the rest of your life? You know, sort of parents, you talked about, you know, children. How does that kind of traveling life fit in with a home? Well,

Ellen: Well, I think I don’t do it anymore because I have got children and, and some people did.

There used to be doctors on board who would bring their family and they’d all stay on board, but I think that only works for so long and it, it’s not really, the cabins are quite small, so having your whole family squashed in one cabin, thinking about schooling. There’s perks, the, the, the, the kids did have a good time seeing all the different places, but I think They need to go to school at some point and it’s not something you can do forever.

So yeah, I think it is something I’m glad I did early on in my career when I wasn’t tied down. Um, but there are ways around things like that. And there are people who do short contracts, go back to their family and friends. [00:15:00] There are ways around it, but if you wanted to do that longer term, then yeah, that’s something that might be it.

And how

Mat: did you, how did you manage to keep This work coming your way because if I’m thinking, you know, in my job, you know, I sort of I’m employed by my trust and you know, they pay me to take out tonsils and I just need to turn up and do what I’m paid for. I don’t need to worry about, you know, am I going to have a job?

Am I going to have a contract? Am I going to get paid? But you know, you’ve repeatedly, you’ve repeatedly had to find work. Employment, paying activities.

Ellen: So it’s again, it’s a bit like the contacts you make. So there’s a medical department in Miami. There’s lots of different cruise ship companies, but I tended to work for the same one.

I did do a few contracts with other ones, but there’s a medical HR department, essentially, who they have to, it’s their job to staff all of the ships in their fleet. And there’s loads of them. I don’t know how many these days, but 20 plus ships all sailing around the world, all needing the doctor. And they need.

To staff their ships, so there’s, there’s no shortage of work really. [00:16:00] You just have to be prepared to be a bit flexible on where you’re going, the timings of it, um.

Mat: How did you find them in the first place? Because there were people listening saying, Oh, I want to do that. And you know, it’s easy because you know, so it’s easy to say it’s easy.

Yeah. Of course you forget it, don’t you? Because

Ellen: you know what you

Mat: know. You know what you know. Yeah.

Ellen: Yeah. Well, it was, so I saw an ad in the BMJ for a cruise ship medicine conference. And, um, It was run by someone called Alan Doobie who used to be a cruise ship doctor himself. He’s an ED consultant in the Midlands and he ran a course at that time to discuss this is what it’s like to work on a cruise ship.

This is what you need. So I went on that course and that was how I found out about it initially. And then he put me in touch with the HR department. But anyone who wants to do it now, There’s various websites around which talk about cruise ship medicine, various companies, and they will all have, um, information on how you can apply.

So generally you need to, [00:17:00] um, I think it’s, I think it’s three or three to five years post grad you need to be and you need to have your ALS, ATLS, APLS certificates, be competent in certain, certain things. But basically you’ve got the cruise ship websites and Google cruise ship doctor and the information will be there.

I’m actually, on a tangent, I’m actually contributing a chapter to a book on portfolio careers and this is by, um, Dr. Patrice, um, Oh, I’ve forgotten her surname. Dr. Patrice Baptiste. So she’s writing a book on portfolio careers and I’ve written about my career and I’ve got lots of links in there about how you can, how you can pursue a career in cruise ship medicine, if that’s of interest.

Mat: I hope you’re enjoying the show. Please click subscribe so you’ll be notified when new episodes become available. This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to one person who you think might benefit from [00:18:00] listening.

Thank you. Now on with the show.

You know, what, what I’m hearing though, sort of moving away from cruise ship medicine, I’m hearing you. I’m hearing in your career, a repeated recognition that what you want to do, you want to do something different. You know, you’ve changed, the world’s changed, the environment’s changed. And then some people will sort of, will stay and moan and complain.

Um, which is probably an awful lot of us. But you know, but what you’ve done is you didn’t just sort of keep, put up with it. You went out there and you made changes. And it sort of strikes me that there’s a mindset in this. And, and there’s, there’s a mindset that goes, well, you know, I’ll make my own luck.

You know, I won’t, I won’t, I won’t be a victim. I won’t sort of say, you know, the world has done this to me. And sit and moan and complain. You’ve gone out there and you’ve made the future happen.

Ellen: Well, yeah, I would say that’s true. And when things weren’t working out on ships as well, I did the same and quit that and then came [00:19:00] back again.

So yeah, I think there’s definitely an element of that, but there’s always opportunities out there if you, if you want to go and look for them, I think. I

Mat: guess people don’t look for them. That’s, that’s the issue because people, people sit back and sort of say, well, you know, it’s all too difficult. So, you know, what, what helps you be like that?

Yeah. You know, as opposed to somebody else who sort of, who, who sits back and says, you know, this is all very difficult and an awful lot of NHS is very difficult. Yeah. Yeah. So I think let’s not pretend that things are always, it’s not, uh, but sort of what you’ve done is you’ve, you’ve got a mindset that means, you know, I’m going to go and do something about it.

So what, what helps you have that kind of a mindset?

Ellen: I don’t know. It’s just the mindset I’ve got. I think when I do those personality quizzes, I’ve got an activist personality. That’s just, it’s just me. I kind of have to do something. So I don’t really know why I have to think about that a bit harder.

Mat: If I think maybe, you know, if it, if it was me and I think that there’d be a little voice on my shoulder to say, oh, but it’s [00:20:00] too difficult, you know, you’re not going to have job security, you know, maybe the work will dry up or, or, you know, or perhaps, perhaps sort of something will happen and, you know, they won’t want you and they won’t want doctors anymore.

Or, you know, maybe somebody is going to invent, you a tablet that’s going to dissolve your tonsils away and they won’t need you to take tonsils. And I can think, oh, you know, there’s all of these risks, you know, I’m just sort of, it’s just easy if I just sort of stay put and, and, you know, complain. So what’s, what’s, what would you say to, to somebody?

I

Ellen: think there’s almost a bit of a, kind of, low grade confidence that there’s always work for doctors, because it’s one of those qualifications, well, we can talk about that in a second, at the minute the work for low income GPs has been drying up and that’s been a bit anxiety provoking, but I think there is always jobs somewhere, maybe not in the UK at the minute, but around the world, there’s, it’s a qualification that’s respected and I think we will always have work and, and I think I’ve demonstrated that wherever I’ve gone, I’ve been able to pick, pick work up [00:21:00] if, if, if I’ve looked for it.

Um, Yeah, as I said just there, law can work at the minute for GPs. It has been drying up and I’m a law firm GP right now, and I lost three of my sessions in January due to this government scheme. I don’t know if you want to talk about politics, but

Mat: So it’s, we, it’s quite, we have quite an international audience as well, Ellen.

So I think probably what, what I’ll say for people, the people in UK At least the GPs will probably know, for people that are not GPs, for people outside of UK, you know, there’s, there’s a new scheme that has come in place, um, which, which means that, that it doesn’t make particular financial success to employ doctors in primary care.

I think that’s a fair

Ellen: summary, isn’t it? Low, low income doctors. So some of the work has been drying up, so that has been quite, well, it’s one of the risks of being a low income. You’ve got job security when you’ve got a job as a salaried GP, excuse me, But as a locum, you have got that flexibility to pick and choose your, your work and your [00:22:00] hours.

But on, on the other hand, there’s a risk of this happening if the practices don’t need you or the work dries up, then you can be left without work. So, so again, when that happened in January, I, I panicked and applied for lots of jobs and then took a step back and I actually have. Continue to have work. It hasn’t been as bad as I thought.

I’ve just got work at the other practices I work for. Um, but I am hearing nationally that there are a lot of law firms who are struggling. And I think it is area dependent, perhaps depends on the contacts you’ve got. Um, So, yeah, back to your original question, I think maybe it is a mindset and maybe it is just the, what’s the word, optimism, always been optimistic that there is going to be something, something there.

Mat: Also, the word that’s coming up for me is flexibility, sort of, in the sense that, you know, you’ve outlined that, I mean, flexibility is a bit of a [00:23:00] double edged sword, yeah, because you know, As you’ve outlined, it’s sort of, it’s good and bad, but what I’m thinking in terms of how your career has panned out, you know, you, you have been very, very flexible because you’ve been able to do things.

You’ve, you’ve multiple times, you know, you’ve made moves across country, across professions, and, you know, and that’s kind of, that’s allowed you to, to craft, you know, what you want. And as you have changed, as your life’s changed, you’ve crafted different things, of course. The mistake that people think is I make a decision at 16 and that’s going to be my life for the rest of eternity.

But you know, as you’ve outlined, all of us change. So that’s an unrealistic thing. But you’ve really embraced that flexibility.

Ellen: And I do think that’s important because we’re different people. from when we’re 16 to what we are mid career and the end of our careers and I think it is important to embrace that and do what’s right for us at those times in our lives.

Mat: I’m wondering in terms of what else you’ve got going on in your background flexibility, so I’m [00:24:00] thinking maybe sort of somebody, somebody who’s a main breadwinner. sort of, they got a partner, children at home, somebody’s got a hundred thousand pounds worth of student debt, um, that they need to pay, or somebody that’s tied, um, down with, um, elderly parents, and that, you know, that needs lots of support, maybe they, they, they perhaps won’t have the kind of flexibility that maybe, and me, and me sort of have enjoyed.

So. Um, it’s, it’s perhaps maybe if I think, you know, I’ve been very lucky on that, but perhaps very fortunate in acknowledging that I’ve been lucky to have had that flexibility. I’m wondering what, what can we, what can we, what can we say to help people whose lives don’t have the flexibility that enables them to have such a flexible career?

Ellen: And I think that that’s, that’s very valid. It, it is difficult to do that, but perhaps I would say that in those sort of instances, the sort of being a portfolio career, perhaps. is more useful because it means you can work around these commitments. So at the minute, I’ve got two young [00:25:00] children. I’m a single mom and I work from home so I can juggle all that.

So I’ve, I’ve actually taken on more sessions than usual this week, but I can, they’re so flexible with the work I’m doing is that I can, once the kids go to bed, I can do a lot of the work afterwards. So there’s a lot of admin work, e consults. Things that I don’t actually have to speak to someone about that I can do and sometimes this portfolio work and flexible being a flexible GP locum can, can work better for people with responsibilities because it means you can work around your other responsibilities.

Mat: And this is your mindset again, isn’t it? And that optimism. Yeah, because I’m thinking, gosh, it must be really, you know, if you’re a mum with two children, you know, how do you manage to be a doctor? And you kind of say, it’s great, you know. Well,

Ellen: no, because it lets me earn. If I, if I had to go and do a nine to five job where I had to go into a hospital or a GP surgery, I couldn’t do it because if you’ve got fixed, it’s very fixed, but [00:26:00] the way I do it now, it means I can do it around everything else.

Mat: So yeah, this is, this is definitely the mindset. I feel like sort of what we need to do when the podcast goes out, we need to try and distill Ellen. And we need to sort of, we need every person that listens to the episode, you know, sort of, we’ll send them a scratch and sniff card that’s going to, that’s going to distill the, the, whatever mindset.

I think that’s what we need. We need to bottle it and sell it. And then we can both retire. We won’t need to work at them anymore. Okay. So if I, if I just sort of think of a portfolio then, so I guess the other thing is that, um, that you perhaps sort of done a lot of stuff sequentially. Right. You know, at the moment, she said, you do locum GP and then you do writing and the writing may or may not be paid.

Um, and you’ve done lots of things sequentially. If I think of how I work, I mean, I’ve done that also, but I do a lot of things [00:27:00] concurrently. So, so my own portfolio career, I kind of say it’s not so much a story, although there is that also, but it’s, it’s, I’m doing lots and lots of different things at the same time.

And, you know, for me, the way, That I would say the big benefit for me is that I have, I have things that I want to do in my life, and I have needs that need to be met, and I have things that frustrate me. And for me, sort of being some doing one job on Monday, something else on Tuesday, something else on Wednesday, I Or whatever it is, you know that that means that that that I never quite reach the frustration level with any of those jobs And i’m sure they don’t frustrate me.

So I never quite quite reach a level of frustration with any of them But equally I have multiple things that I want to do and those jobs allow me Sort of to take, you know, the three or four different things that I want in my life that otherwise Um, I wouldn’t able to do I wouldn’t be able to to meet those needs in my career.

That sort of sounds does that resonate

Ellen: with you? Yeah, definitely. So example, I said i’ve got more work than usual this [00:28:00] week and on Friday i’m up here I’ve found myself getting frustrated because it’s been Probably a bit too much and I haven’t had as much chance to do some of the other things such as the writing um But yeah, definitely.

I think it, you can often maybe do the job better if you’ve got more space to do with the things that you enjoy. And that’s particularly relevant in general practice. We’ve got GPs burning out, we’ve got 2, 000 less GPs in the NHS since, than we did in 2015, and people are leaving because of the pressures.

And being a part time GP is one of the things that the press and commentators have a go at GPs about and see it as a very bad thing. But again, I see it as a very positive thing because being a part time GP, you can actually Give more time to the job and you’re not going to burn out as much. I

Mat: learned this in Australia.

This was, you know, one of the defining things that I took away in terms of my own career from my fellowship in Australia is, is that, you know, people did, they did the [00:29:00] public hospital on Monday. Then they did a children’s gospel on Tuesday. They were in a private room on Wednesdays. You know, they were in a tertiary center on Thursdays.

And you know, Friday morning, so today we’re in somebody else’s private room. So everybody constantly sort of traveled from one role to another. And one of the things that I saw is, is that the, I, I saw people, I think the people were much happier. The Australian doctors, you know, this would’ve been 2011, 12.

They were much, they were much more fulfilled than we were as doc, as doctors in uk, I think. And what I took away from that, it it’s because the, the focus was on being a doctor on sort of on, on, on the stuff that they enjoy. They went in and sort of, and then they did doc, they, they, they, they did medicine.

They got paid for what they did and then they went home. And the issue that sort of, that maybe the challenge that we have in uk. And also sort of maybe for people in US, because I know a lot of a lot of the US listeners will spend hours charting in the evening is that we’ve lost that link. You don’t you don’t go in and you do your job is, you know, in UK as we go [00:30:00] in and then we worry about audits and portfolio and research governance.

And in the States, people go and see the patients and then they spend another three hours at home, you know, entering the electronic patient records, hopefully they remember. what they said to the patient, but it’s that kind of that ability to enjoy the job that was there in Australia for the doctors.

They came in, they loved the patient work, and then they went home. Um, and it kind of, it feels like a little, an element of that is missing. But again, you know, if I kind of think for the portfolio careers, if you, if you know, you know, there’s a defined element that you do that has clear boundaries around it, we can go in And we can enjoy that job and then we can go away and sort of, we can do rest or, or, you know, rest might be doing nothing.

Rest might be doing your other job. Rest might be writing. Yeah. So it’s, you know, it’s, it’s a change and it’s that, as you say, that, that enables people to enjoy the job rather than think, Oh gosh, you know, the more people I see, the more, the more results I have to look at, you know, the more, the more charting I have to do at eight o’clock, nine o’clock [00:31:00] at night when you’re not supposed to be working.

Ellen: And it’s very much feels like a lot of service provision in the NHS, because what you said about Australia, I remember in New Zealand feeling very much the same, and it’s probably a similar, similar ethos there. And the teams, it was, it was, it’s a smaller country, but in the hospitals, the teams are smaller.

Everyone knew each other. Even when you rotated in the hospital, it was small enough that you knew everybody and the consultants knew the juniors. They had a mess. And on a Friday, I remember they would have pizza and beers and the mess and. That’s gone from the uk and I think that’s really, IM important.

That makes the job, it makes you feel more human to to have that connection with your

Mat: colleagues. The, the irony is that, you know, the, the, the in in general practices used to be Wednesday afternoons, isn’t it? You know, GP used to close on Wednesday afternoon because, you know, ’cause everybody did team building in hospitals used to be Friday afternoon.

Yeah. And you know that, that, that ceased to most people listening won’t know that that ever existed. Yeah. Oh yeah. But that, that was a thing. And, and people say, oh, you know, it’s really [00:32:00] unproductive, like the whole, every operating theatre closes on a Friday afternoon. How wasteful is that? But, but the irony is that, that it was that that allowed people to work really hard for, for year after year after year, day after day after day.

Whereas, you know, sort of, we’ve let some of that kind of stuff go, and now we’ve got people that can’t work really hard day after day and year after year. Um, so that, that’s kind of, So it’s a slightly, slightly weird thing that we think we’ve made ourselves more effective and more efficient, but actually we’ve made ourselves less.

We

Ellen: really haven’t, have we? Because we’re people, we’re not machines and that’s so important. And the best companies like Google and Amazon, they really look after their staff and give their staff all these perks. And in the NHS, you’re lucky if you, if you, if you take a cup of tea from the ward, you’re going to get into trouble.

If you have to pay for your parking, you have to get food from vendor machines if you’re lucky. And all those things make, they matter.

Mat: And that probably is, you know, the [00:33:00] GP.

Ellen: Well, that’s different. But yeah, there’s many aspects to that question. And yeah, I won’t talk about that now. So I mean,

Mat: you said that some of the work that you do, like the writing is paid and some of it is not paid.

So somebody might be thinking, OK, I really fancy a portfolio career. Um, and, um, you know, with the kind of discussions that I have, you know, people think, you know, I want to get a job and I want, you know, I want to have a portfolio career. I want to take on another role. I want that role to pay me as well as my medical salary pays me.

So I’m interested that you said that you’re doing stuff. That doesn’t pay or it pays very little.

Ellen: So what, yeah, sorry, of course, what I was talking about there is more the work I’ve done with the Doctor’s Association. So that’s a voluntary organization. And I started there as an editorial lead. So I was writing a lot of press releases and a lot of material for such as letters to MPs and all of that work was unpaid.

When [00:34:00] it comes to articles in the media, again, when I first started out, there was a, there was definitely a sway and medics do this. I do this a lot, to write things unpaid, and I think we do that a lot for our CVs. I remember writing a lot of articles, or doing, um, papers when I was more of a junior, and you just do it for free because it’s good CV material.

But actually, we’re doing ourself a disservice, and All of my journalist friends would be shocked at the fact we’d write articles for free for the, um, I guess if you’re doing it for a platform or to get an issue across. That’s why we did it with D. E. K. But we should charge for our work. Journalists get paid and we should get paid too.

So I think if you are starting off as a writer, I think you should speak up for yourself and get paid for the work you do. And when you negotiate an article with whoever you’re negotiating with, I think talking about the pay should be part of that.

Mat: If you [00:35:00] think about portfolio careers in general, you know, for somebody who’s going to say, I want to move, you know, into X, Y, and Z, then if they have no connections, no credibility, No relationships, you know, not nothing to fall back on.

What’s the role, what’s the role in doing stuff

Ellen: for free? Yeah, well, and then that’s difficult because I guess you do have to establish yourself and build yourself up and you could do that. I guess maybe that’s something I was, I did early on in my career and wrote for student magazines and things like that.

But at some point you have to value the work that you’re doing and you’re spending time doing it. And A lot of, a lot of newspapers do ask for opinion pieces, so you could do it that way, but, but they do pay as well. So I think it just should always be the question you ask, even if you’re on you and starting out, your work is of value.

If they don’t like it and it’s rubbish, fair enough, but at least, at least you can, you can try. Um.

Mat: I like that as a, as a, as an idea to, to always, [00:36:00] um, ask that question, because I think it is difficult, you know, whatever, whatever, whatever people might branch out into is, is, you know, chances are that you won’t, you won’t know anything. And I think, you know, for me, if I kind of think the things that have worked well for me is partly has been about.

It’s been about, um, upskilling myself and, you know, kind of with you and your writing, you know, that that’s always been there. And if I think of some of the career sideways moves that I’ve made, I kind of, you know, was not quite starting from scratch, but, you know, I had no credibility. So, so it was about, you know, for me, it kind of started with learning and, and then being really good.

Yeah, what I do. Um, and then then if I’m if I’m well trained and I’m good at what I do then Then it’s it becomes much easier to get paid work along those lines because you know Partly because I know that I’m good at what I do and that I’m that I’m worth whatever people might want to pay me But also because it’s easy for me to demonstrate my worth to other [00:37:00] people and maybe you know if you’re talking about writing is is you know sort of here’s a list of what I’ve done and that might be research papers and and audits articles presentations you know it’s all it’s all evidence that people have done and sort of and it’s thinking strategically and and and collecting that and and again you know if I kind of think you know Some of the roles, I know lots of people are kind of interested in medical education, you know, or in leadership or people interested in coaching or sustainability.

So, you know, all of those kinds of things, everybody has to start somewhere. And it’s, it’s, if you’re, if you’re, So, if you’re good, it becomes easier and easier, sort of, to try and make a career out of things, isn’t it? But it’s perhaps not, you, but not at the beginning, if I think, you know, when you’re writing these papers, you won’t earn any money from that.

Yeah. No, not

Ellen: at all. But even now, the last three books I’ve done, but this is my decision, I don’t make anything for them either, but that’s because I’ve donated the royalties, just because I felt some of the topics I talk about, people could turn around and say, Oh, well, you’re making money from this book.

[00:38:00] So, it was more as a platform, I wrote the book because Yeah, there’s an issue I want to talk about. Yeah, writing doesn’t make an awful lot of money unless you’re a best selling author. But, um, but yeah, there’s certain articles you can still write for newspapers where you can, you can earn something for the time that you’ve spent doing them.

Mat: So that for me would kind of come into the category of thought leadership. That, that, you know, you are, you are, you are, you are doing stuff that’s establishing you or I’m doing stuff that’s establishing me, um, as a thought leader. And it doesn’t necessarily create any income, but, but it sort of, it gives, it gives visibility.

Sure. Sort of, and, and establishes you as a thought leader. And that then leads sort of to Yeah. The opportunities

Ellen: for sure. Yeah.

Mat: Okay. Um, I wonder maybe if I could bring us to a, to a closer me, we talked about lots of different things. Perhaps if I could ask you to summarize. What we talked about and, you know, what would be your top tips for doctors at work if they’re thinking about a portfolio career?

Ellen: Well, I think go for [00:39:00] it. Follow your heart, do what you want to do. Um, to use a lot of cliches, you can’t pour for an empty cup, so you have to look after yourself really. And especially in the current climate in the NHS, it is hard. It’s difficult out there. And if you can branch out and do other things to keep yourself sane, then I would say go for it.

Mat: Wonderful. Thank you very much. Lovely.

Ellen: Thank you for having me.

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