How to prepare for being a Consultant
What the textbooks don’t tell you and how to set up in private practice
Charlie Chan - Cheltenham
The New Boy or GirlBeginner’s Guide
First two years are the most challenging
Get it right, as it’s hard to catch up
Two jobs or One?
Not everyone wants to do private practice
But if you do, then you will have two jobs
Time management and organisation are the keys to success and will stop you going mad
NHS JobBEFORE the interview ask about
SECRETARY
OFFICE
Theatre Equipment
Travelling – peripheral clinics
MAKE IT CLEAR WHAT YOU MIGHT EXPECT IF YOU GET THE JOB
Everyone needs Miss Moneypenny
Your secretary is worth her weight in gold
Try and choose your secretary yourself
Tell the hospital when you get the job that you want to make the appointment
The OfficeAsk about the office when you come for pre-interview visit
Do not accept a broom cupboard when you arrive
It has to fit you, your PA plus your paraphernalia
Other essentials
Theatre equipment – will there be a small budget for you to buy your favourite bits?
Do you have to travel?
Who do you have to support you?
Mentor
Keep in touch with an old boss
It’s ok to call him/her for advice
Appraisal
Logbook
CPD records
Thank you cards & compliments
Complaints
(360 MSF later)
Thank you cardsIf someone writes or gives you a present
Write back!
Keep a copy of the card/letter and reply in the notes. It might just save your bacon!
Keep a copy for your Portfolio
Private Practice
Still the 4 As
Availability
Affability
Affordability
Ability
When to start Private Practice?
Think about it before you start the job
You will get asked in the first month or two by a NHS patient, who is insured
It takes time to organise
What do you need to do?
Get recognition from insurance companies
Tell your Medical Defence Organisation
Visit your local private hospital to arrange practice privileges (PPs)
Think about secretarial support
Sort out a bank account and accountant
Money
Remember that the contract is between you and the patient
You treat the patient and charge a “customary fee”
The patient is liable for the fees
The insurance company reimburses (either you directly or the patient)
FIPO charter
http://www.fipo.org/pdfs/FIPO_Patient_Charter.pdf
Insurance companies
You will need to be recognised
You need to apply to each insurer individually
Letter of appointment to substantive post
Specialist Register entry
References from consultant colleagues
Not all insurers are the same
BUPA 42%
AXA PPP circa 20%
Aviva, Pru Health, WPA, SimplyHealth, CIGNA
Exeter Friendly, Multiplex, Westfield, Beneden, Healix, Saga, Permanent Health, Universal Provident, Health On Line etc
Fee assured consultants
BUPA and AXA PPP – 65% of the market
BUPA and AXA PPP set the fees, NOT you
You bill them directly – no shortfalls or billing patient
BUPA have just reduced the reimbursement for 60% of the most common procedures by average 25% below 1992 levels
Currently
You might expect to spend c. 35-40% of your income on practice expenses
i.e. 60-65% is net income subject to income tax
If insurers squeeze doctors hard, this might go up to 60-65%
i.e. only 35-40% remains subject to income tax
Practice PrivilegesNeeded for every private hospital you wish to
work at
Visit Hospital Manager
Complete application form
Included letter of appointment, specialist registration, references
Occupational Health screening
Awarded by MAC (Medical Advisory Committee)
How do you get known?
The patients are your customers
The GPs are your corporate customers
Write to the GPs
Offer to visit them
CALL THE GP WHEN YOU HAVE BAD NEWS OR A PROBLEM WITH A PT – NHS OR PP
Give them your mobile number
Manage your time
Learn to say NO!
Do not take anything else on in your first year or two
Concentrate on getting your feet under the table
Enjoy it!
Finally be polite
Never be rude to anyone – you never know who their best friend might be
You cannot divorce your consultant colleagues
Smile and make it enjoyable
Your patients will notice – they will tell their GPs – you will get more work!
Insurance companies
BUPA AXA PPP
WPA Clinicare
CIGNA Legal & General
Aviva Healthnow
Simply Health QBE Health
PRU Health Groupama
Exeter Friendly Health On Line
Universal Provident Permanent Health
Benenden Saga Health
Civil Service Healthcare Healix