April 2019 Issue 110
www.independent-practitioner-today.co.uk
INDEPENDENT PRACTITIONER TODAY
Beautiful or bound?
The business journal for doctors in private practice
In this issue All hell to pay
An accountant advises on the most common business howlers that trip practices up P18
How crises cause brain block Our series on eliminating human error looks at how best to manage crises P34
£12.50
Salaried consultant jobs in private practice have their critics, but four specialists tell us why they enjoy their new employed status n See page 26
Beware the pension tax taper
A financial adviser and an accountant give their views on tackling the flaming tax headache P48
Courts are after you!
By Robin Stride
A recruitment drive is underway to find consultants and GPs who want to increase their private incomes by taking on legal work. They are needed for often lucrative employment in writing reports and giving court evidence as expert medical witnesses. A shortage of doctors taking on these roles was highlighted at a BMA medico-legal conference where some of the 110 specialists indicated they charged £400+ an hour for the work. Negligence barrister Dr Simon Fox QC, who generally instructs in cases exceeding £1m in value, told attendees to ‘spread the word’
about doctor shortages in this field. He described medical expert witness duties as ‘interesting and well paid’. However, consultants and GPs at the meeting revealed a huge discrepancy in the fees they charge for their expertise. Of 110 present, a show of hands found most doctors charged £250 an hour or under, while others were getting £300£350 and beyond. The survey was stopped before it revealed how much the highest earner was paid. BMA medico-legal committee chairman Dr Jan Wise ran the ‘hands-up’ study in response to a doctor’s question about how much a ‘reasonable’ fee would be. He suggested that doctors should
factor in everything that might be relevant, such as their NHS equivalent rate, holidays and pension. They should keep a real record, like solicitors, of the time they spent on medical expert witness work. Dr Wise said their fee should be much closer to those in the audience who were at the higher end, adding: ‘We are probably all undercharging’. In the light of new evidence, some doctors are now reviewing their fees. Dr Wise told Independent Pract itioner Today later that the dearth of experts had a range of contributing factors. ‘While the intellectual rigour and the adversarial atmosphere of the court appeals to some, the
ability of a barrister – a compelling narrator, orally articulate – deters many doctors from engaging in expert witness work. ‘As the trained Rottweilers of our legal system, they are supremely able to persuade the listener to accept the righteousness of their cause.’ He said the deterrents to becoming an expert witness seemed ‘nigh on insurmountable’. These included lawyer intimidation, an employment regime where adjusting job plans to accommodate the work or time to give evidence was a Sisyphean task – as well as the detriment to existing patient care – and the impact of vexatious complaints to a regulator. ➱ continued on page 3
KAT’S GOT THE CREAM Former GP Dr Anahita Mansouri, consultant gynaecologist Miss Poonam Pradhan, consultant plastic surgeon Mrs Chien C. Kat and aesthetic nurse specialist Natasha Rankin have got together to launch a new ‘super-clinic’ for patients in and around Birmingham. Mrs Kat said: ‘Most of our aesthetic clients are female and many feel comfortable with having a consultation with a woman because they feel we understand their needs.’ n See story on page 5
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