Managing Staff in a Medical Practice: A Practice Manager’s Guide to People Management

People management is the hardest part of the practice manager role. The skills, systems, and legal framework you use to hire, roster, develop, and retain a GP practice team are the difference between a clinic that runs smoothly and one that cycles through staff every six months. This guide covers the full HR landscape for Australian general practice, from the Health Professionals and Support Services Award to performance conversations, team culture, and knowing when to call in a specialist.

The People Challenge in Medical Practices

General practice runs on a tight ecosystem of GPs, nurses, receptionists, and practice managers (often fewer than 20 people in a single building). That small size amplifies every interpersonal dynamic. A single disengaged receptionist affects patient experience across hundreds of consultations a week. One nurse who clashes with a GP makes every shift harder for everyone.

Practice managers inherit this complexity without the people-management support structures that larger organisations take for granted. There is no HR department to escalate to, no dedicated recruiter, and often no formal performance framework. The practice manager has to build those structures while also running billing, compliance, and operations.

The clinical-administrative divide adds another layer. GPs and nurses operate from a clinical hierarchy; receptionists and admin staff operate from a service delivery model. Bridging those cultures (getting a GP to understand why front-desk morale matters, or getting reception staff to understand clinical urgency) is one of the most underrated skills a practice manager develops over time.

The good news: the HR fundamentals that apply to general practice are learnable, and there is a clear legal framework to work within. The practice management discipline is built around exactly these operational skills.

Employment Framework for Medical Practice Staff

Most GP practice staff, including receptionists, medical secretaries, practice managers, and healthcare support workers, are covered by the Health Professionals and Support Services Award 2020 (the HPSS Award). This Modern Award sets the minimum pay rates, penalty rates, overtime conditions, and leave entitlements for healthcare administrative and support roles across Australia.

Understanding the HPSS Award is not optional. Practice managers are responsible for ensuring their practice complies, and getting it wrong, even accidentally, exposes the practice to Fair Work claims, back-pay obligations, and reputational damage.

The National Employment Standards (NES) sit above the Award and apply to all employees regardless of what their contract says. The NES covers the 11 minimum entitlements, including annual leave, personal/carer’s leave, parental leave, notice periods, and the Fair Work Information Statement. If a contract offers less than the NES, the NES prevails.

For anything beyond standard pay and leave questions, particularly redundancy, serious misconduct, or unfair dismissal concerns, the practice manager’s first call should be Fair Work Australia (1300 799 675), the Australian Medical Association (AMA) branch in your state, or an employment lawyer. This guide provides a framework; it does not constitute legal advice about specific employment situations.

Rostering and Workforce Planning

Rostering in a medical practice is more complex than it looks. Session demand varies by day, time, and GP availability. Leave, professional development days, and unplanned absences create coverage gaps. A well-built roster manages these variables without over-staffing (which blows the wage budget) or under-staffing (which burns out the team and degrades patient experience).

A practical approach for small practices:

Practice management software typically includes rostering modules. Most practices use Best Practice, Medical Director, or Genie Health for clinical scheduling. See the related article on what practice managers earn in Australia for context on what the role demands relative to its remuneration.

Recruitment and Onboarding

Recruiting for a medical practice is different from recruiting for a commercial business. Candidates need to understand clinical confidentiality, patient interaction standards, and the specific compliance obligations of a healthcare setting from day one. A strong onboarding programme is the fastest way to embed those standards.

Writing position descriptions

A position description for a medical receptionist should cover: the core duties (patient check-in, appointment scheduling, Medicare billing, phone management), the technical requirements (specific PMS software, scanning, results management), the interpersonal requirements (patient-facing communication, clinical team interface), and the compliance obligations (privacy, confidentiality, mandatory reporting awareness).

Be specific about working conditions, including Saturday rostering, after-hours expectations, and whether the role is part-time or full-time. Unclear position descriptions are one of the main causes of early-tenure resignation.

Onboarding checklist

The first 30 days are when most new hires decide whether they stay. Regular check-ins during this period let you catch small issues before they become reasons to leave. The 10 skills every Australian practice manager needs article covers the broader capability set, including the people leadership dimension.

Managing Performance

Performance management in a small medical practice is not about bureaucracy. It is about having direct conversations early, setting clear expectations, and documenting what was agreed. When those foundations are in place, most performance issues resolve before they escalate.

Setting expectations

Every team member should know what “good” looks like in their role. For a receptionist, that might include specific metrics (phone answer time, appointment schedule accuracy) and behavioural expectations (patient communication tone, escalation protocols for clinical queries). Written position descriptions and regular 1:1 conversations are the vehicles for this, not a once-a-year appraisal.

Regular 1:1s

A brief fortnightly or monthly 1:1 between the practice manager and each direct report normalises feedback, catches issues early, and builds the trust required for difficult conversations later. Keep a simple record of what was discussed and any actions agreed. If a performance issue develops, that record is invaluable evidence that expectations were communicated and the conversation happened.

Performance improvement plans

A performance improvement plan (PIP) should be a structured, fair process, not a precursor to dismissal. A compliant PIP under Fair Work principles includes: a clear description of the performance issue, the standard expected, specific actions required, a support plan (training, supervision, check-ins), a review timeline, and the consequence if the standard is not met.

For anything involving potential termination, seek advice from Fair Work Australia, your AMA branch, or an employment lawyer before proceeding. Unfair dismissal claims are a real risk for practices that skip process steps, even where the underlying performance concern is genuine.

Building a Positive Team Culture in a Medical Practice

Team culture in a GP practice is shaped by three things: how the GPs behave, how the practice manager leads, and the systems that structure the day. A practice manager cannot control GP personalities, but they can create the conditions in which positive behaviour is the norm and problematic behaviour has a clear response pathway.

Recognition and communication

Small, consistent acts of recognition matter more than annual events. A direct “thank you” after a difficult day, a brief mention in the team meeting of someone who handled a complaint well, or a written note to mark a work anniversary. These cost nothing and build significant loyalty over time. Be specific in recognition: “You handled that distressed patient really well this morning” lands better than “Good job today.”

Regular team communication prevents the information vacuum that breeds rumour. A short monthly team meeting (15 to 20 minutes, standing format) covering any practice changes, upcoming events, and any shared concerns keeps everyone oriented. Post a brief written summary for staff who could not attend.

Managing the clinical-administrative divide

GPs and nurses operate from clinical priority. Reception and admin staff operate from patient flow and schedule logic. These two perspectives regularly collide. A GP running 45 minutes late while reception manages a waiting room full of patients is a daily stress point in most practices.

The practice manager’s role is to translate between these worlds. Build explicit protocols for the most common friction points: how GPs communicate delays, how reception escalates clinical queries, what “urgent” means in different contexts. Written protocols reduce the interpersonal friction that comes from repeated improvisation.

Handling GP-driven culture issues diplomatically

GPs are typically the practice owners or senior clinical figures, which makes addressing their behaviour toward staff one of the harder conversations in practice management. The most effective approach is to frame it in operational rather than personal terms: “When this happens, it creates this outcome for patients and the team” rather than “Your behaviour is unacceptable.”

Document specific incidents. Bring data where possible. Have the conversation privately, away from the clinical day. If the issue is serious or persistent, the practice’s governance structure (whether that is a partnership meeting, a board, or a corporate owner) is the right escalation pathway.

For a broader perspective on what the role demands day to day, see a day in the life of a practice manager.

Common HR Challenges in General Practice

Some HR challenges appear in nearly every GP practice. Knowing the pattern helps you recognise them early and respond before they become crises.

When to Escalate to HR Specialists

Practice managers are skilled generalists. Most HR matters in a small practice sit within the scope of a competent, well-trained practice manager. But some situations require specialist knowledge that goes beyond that scope, and attempting to handle them without expert support exposes the practice to significant legal and financial risk.

Escalate to an employment lawyer, HR consultant, or your AMA state branch employment advisory service when:

The cost of professional advice is always less than the cost of an unfair dismissal settlement or a Fair Work investigation. Build a relationship with your state AMA branch employment advisory service before you need it. It is an underutilised resource for GP practice managers.

For the broader governance context within which people management sits, the cross-hub article on what is clinical governance is worth reading. People systems are a core component of clinical governance in any practice setting.

People management is a core competency of the HLT57715 Diploma of Practice Management delivered by TalentMed (RTO 22151). The qualification covers HR frameworks, workforce planning, employment law foundations, and the operational skills to lead a general practice team effectively. It is 12 months, 100% online, self-paced, and VSL-approved for eligible students.

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