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