How long have you been in private practice?
12 years.
Are you still in NHS practice? If so, is this full time (10 or more PA) or less than full time?
Yes, full time.
How soon after starting in NHS practice did you start seeing private patients?
9 months.
Please can you describe your private practice?
I see predominantly self pay and privately insured patients through Knee Specialists, but we also have a small proportion of NHS Choose and Book patients. My practice is exclusively knee both in the NHS and private sectors. I see patients with chondral, meniscal or ligament problems as well as early arthritic patients with a view to joint preserving surgery. However when the knee is worn out, replacement surgery has excellent outcomes, both partial and total knee replacement. I am also able to offer assessment and treatment of the painful or worn out knee replacement, sometimes with revision knee surgery.
Do you work formally with other clinicians?
In both the NHS and private sectors I work with other specialist knee surgeons. We have a dedicated sub-specialist practice of knee surgery in both the AOC at Southmead Hospital and Knee Specialists LLP at the Spire Bristol, where there are seven partners in the practice.
Have you established a brand associated with your practice?
Yes. We chose to form a partnership early on in Private Practice. This was to maintain the best possible working relationships with our colleagues whilst providing the best possible care of patients with knee problems, using multi-professional review where this is indicated. Our brand is Knee Specialists, which requres no explanation!
Do you advertise?
We do advertise, but only limited amounts. We have always supported local sports clubs and events, but more recently have also run a couple of more active campaigns, using the back of buses in Bristol for twelve months and then a digital poster board on a busy junction on the outskirts of Bristol.
What is your business vehicle (sole trader, LLP, corporation etc)?
www.kneespecialists.co.uk
KS is a Limited Liability Partnership and this has been in existence for 10 years.
Do you own any equipment that you use in your private practice?
We rent office space and are invoiced for secretaries by Spire Bristol. We do not own any equipment.
What tips do you have regarding being successful in private practice in general?
Private practice is simply medicine as in the NHS, but funded differently. My best tip is to stay true to your core values as a doctor! It is important to remember where your referrals come from; it may be sensible to offer education sessions to keep referrers up to date in your specialist area.
What do you see as the biggest threat to your private practice?
Managed care from some private medical insurers. Placing a value on quality care from an experienced clinician is very difficult, and I understand why insurance companies try to lower costs each year. As a consumer of private medicine, with my family being health-insured I understand the drive to lower premiums, but when I want to access medical care I need to be able to choose whoever I want to see, not being triaged by less-experienced providers than the GP that has referred me. Thankfully the major providers are starting to realise this; experienced clinicians may be more expensive, but they also have low complication rates and high patient satisfaction, which reduces overall insurance-cost and means clients are more likely to renew their policies.
If you work in a private hospital, what aspects of your relationship with the hospital have been most important?
The most important aspect for me is the front line telephone answer that a patient receives when they call our office, or the email reply to a mail. This first interaction is critical. After this, one can identify any area of a hospital as important; radiology, theatres, physiotherapy, nursing........the list goes on. However, when something is not working, it is vital to be able to talk frankly and in a timely fashion with the Hospital Director; good Directors are accessible, firm yet fair, and open to new (sensible!) ideas.
Do you have any tips regarding doing private practice within the NHS setting?
No experience here as this is not possible in our Trust for Orthopaedics.
What mistakes do you think you have made in your private practice to date?
Don’t assume things will keep ticking along, one needs to monitor - have regular meetings with your secretary to look through bookings in clinic and theatre. This will show drop off in referrals or under/overbooked lists...pre-empting this will stop the problem!
What advice would you give to someone starting out in private practice today?
Do not rush. Take time to build your reputation. Always do the same in both PP and NHS sectors.
Do you have any further comments?
Good luck and I hope you enjoy your private practice as much as I do.
