Dev Lall

To run a successful private practice, you’ve got to be comfortable with making money

One of the biggest problems with private practice is that right from the beginning it’s a fight.

And the worst thing about that fight is that it’s an internal one, a battle with ones’ own altruistic nature.

The problem started even before we went to medical school. Because the vast majority of us chose a career in medicine simply to help people. The answer we all trotted out at interview is no less true for being a cliché. That’s why it’s a cliché.

And as we climbed through the ranks as trainees, that desire to help people didn’t change one jot. If anything it was reinforced.

We knew we were obliged to see any patient that was referred to us for an opinion. And we happily did see any patient, anytime, day or night. Offer our opinion and if necessary take over the patients’ care.

At no stage did we ever ask for any kind of recompense, neither from the referring clinician nor the patient themselves (although that dark day may dawn sooner than any of us realises.)

And then one day we find ourselves holding the lofty post of consultant. And everything is different, because now we are able to charge patients for our personal one-on-one private care.

For many of us that is something of a shock.

Because we’ve been so used to giving away our expertise for free to anyone that requests it we now feel very uncomfortable asking people for money. Particularly when we know that if the patient would have just a little patience and go through their GP that we would be able to see them on the NHS without (generally) a consequential delay.

Some consultants never get over this. They never get comfortable with asking patients for money and eventually give up private practice.

A few get very relaxed about this very quickly and go on to create thriving practices – empires even – often leaving the NHS completely.

But for most of us charging patients for our expertise continues to cause unease. We never get truly comfortable with it.

In my experience, until and unless you become comfortable with charging patients for your personal time and expertise, you’ll never really fulfill your potential in private practice.

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