July-August 2022 Issue 144
www.independent-practitioner-today.co.uk
INDEPENDENT PRACTITIONER TODAY
The business journal for doctors in private practice
In this issue
Careful when contracting others
A recent court case has re-affirmed precedents about vicarious liability, which could be costly for doctors P20
Give them a great initial experience
Delivering a good first impression is key to retaining a patient P28
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You think you’re a whizz at medical billing? Answer this quiz to find out how you fare in the billing and collection stakes P34
Inflation’s perfect storm By Robin Stride Consultants’ representatives have warned that mounting inflation coupled with other business pres sures are creating ‘a perfect storm’ threatening private practice. T h e L o n d o n C o n s u l t a n t s’ Association (LCA) has expressed ‘growing fears’ about the future of private practice, while the Fed eration of Independent Pract itioner Organisations (FIPO) vo i c e d c o n c e r n s t h a t h e f t y expense increases made it ‘increas ingly unattractive’. LCA chairman Dr Mark Vander pump said: ‘A perfect storm of external pressures and changes in the market has resulted in a situa tion discouraging to both existing consultants and those who might have been considering entry. ‘The LCA believes that in the longer term this situation repre sents not only an existential threat to private practice but also threat ens the ability of patients to choose the consultant with the expertise most relevant to their needs.’ He reported that the LCA was seeing consultants frustrated at all levels of their careers over signifi cantly increased costs while fees and re-imbursements had stayed ‘static’ for many years. Dr Vanderpump told Independent Practitioner Today: ‘An important issue for all is the attitude of private medical insurers (PMIs) to consult In association with
More established consultants are being delisted [by insurers] for refusing to accept significantly reduced payments DR MARK VANDERPUMP Chairman of the London Consultants Association
ants. Those newly appointed are forced to agree to low professional re-imbursements to be “listed”. ‘More established consultants are being delisted for refusing to accept significantly reduced payments. In addition, there is a lack of clarity over which consultants are being selected for patients who book via the open private medical insurance referral pathways. ‘Decisions about patients’ clini cal care are made remotely by those who have not examined t he patient,’ he added. He believed t he pandemicinduced closure of private hospi tals and clinics had exacerbated the mood of the consultant body, which felt its expertise was undervalued. Dr Vanderpump said a salaried
model might attract some specialties, but could prove restrict ing long term due to a loss of a key attraction of private practice – pro fessional independence. He pledged LCA help for consult ants in all phases of their private practice, including supporting younger doctors through the diffi cult early phase of setting up a pri vate practice. ‘ We offer newly-appointed consultants a support network, including an appraisal service, medico-legal training and access to senior members providing mentor ship.’ FIPO predicted many young con sultants would be put off entering private practice due to high startup costs and low re-imbursements from private medical insurers.
Others would leave as the finan cial and administrative burden of running a practice became uneco nomic. It said: ‘The latest inflation rate of 9%, which is expected to rise to 11% by the end of the year, when combined with rising indemnity insurance and other costs makes private practice an increasingly unattractive prospect. ‘As more and more consultants leave private practice or do not join, the pool for patients to choose from for their treatment reduces. This is further reduced by some restrictive policies of the PMIs when often only two consult ants may be offered to a patient.’ FIPO stated that consultants’ re-imbursements had been con tinually eroded by inflation since the last substantive increase in 1993 and young consultants start ing in private practice from 2010 had seen no increase to take account of inflation. These doctors, who it said were only recognised by the main insur ers if they accepted low reimburse ment rates, should have had fees raised up until the beginning of this year by an annual 2.36% to keep up with inflation. Re-imbursements had, in effect, remained flat since 1993. ‘Consul tation fees have indeed increased, but procedural fees with only a few exceptions have remained static.’ ➱ continued on page 3