Let me take you back to August 2012 – a very challenging time.
I had been a GP partner in an NHS surgery for 16 years, and what began as a wonderful vocation with a good work-life balance had, over successive years, been eroded into a micro-managed, tick-box, underpaying, morale-grinding disaster area.
So I was not happy – and changes to my personal life made me look at my role as a local GP. It just was not an area of stability anymore and I was seriously considering my future as a doctor.
However, like most of my colleagues, ‘I can’t do anything else’ was the recurring phrase that put me behind that desk day after day. And no self-respecting actuary would have given me good odds on making it to the retirement golf course in my early 40s .
Then opportunity knocked. There was a slight glimmer of hope. I would join a group of doctors looking after some fee-paying patients in a private hospital, a change of scene, albeit for one morning per week. So, naturally, I said yes.
Seeing three patients per clinic wasn’t exactly going to get me a hotline to the Porsche showroom. But what a joy – 30-minute consultations; no QOF (Quality and Outcomes Framework); free breakfast!
Within three months, not only was I beginning to think like an independent practitioner, but with the migration of colleagues for various reasons, I soon found myself jointly running the practice.
I moved to a three day week with the NHS and two days running the private service, generating interest and patients from my new hospital consultant colleagues.
In the Summer of 2013, I was put in a quandary. I took a call from an old colleague who had heard of my foray to the private sector. He himself had been running a small but very successful independent practice for some years, and thought that I would be ideal to take over his clinic and he put the proposition to me.
Move to the ‘dark side’
I wanted to continue my work at the private hospital and would have to negotiate the means to work in both places simultaneously, but it would mean that, after 22 years as an NHS doctor and 18 years as an NHS GP, I would have to give up the NHS altogether. Though it was stressful and worked me to the bone, the NHS did offer that regular monthly salary.
I said yes. I saw my last NHS patient a year ago and my move to the ‘dark side’ was complete.
Though fearful of the unknown, there was also a sense of adventure and pride that I was taking this step and, last February, I took over the reins of my very own clinic, Essex Private Doctors, in Shenfield with three staff, two rooms and one hot seat.
What does a private GP with his own clinic have to expect? Initially, I was met with bills . . . rent, rate, staff costs, supplies and sundries, and with not a full clinic list. And so I was left a little reeling.
This is before I even got involved with applying for Care Quality Commission management approval.
What I did have now though was time. Glorious time. Necessity being the mother of all invention, my next step was to become a businessman and look into different ways of generating an income stream.
This led me down the seemingly inevitable path toward the aesthetic arena, which is growing every moment, it seems.
A course in botulinum toxin and fillers led me to skin peels, dermarollers, radio-frequency assisted body contouring and skin tightening, and facial vein treatments.
I am now fascinated with laser technology and already been preliminarily trained on the use of a CO2 laser for skin and aesthetic care.
During this time, I also passed the Diploma in Dermatology exam to shore up my skin knowledge – and add more letters after my name.
Three months into my private venture, a trusted friend introduced me to a Harley Street plastic surgeon and, as we talked, we covered a lot of common ground and it was clear that we shared the same philosophies in health care.
He put forward the idea of my working with him with a view to eventually taking over his business – handling the non-surgical aesthetics and being trained in minimally invasive cosmetic work, referring the more involved cases to a partnered plastic surgeon.
I felt this was an amazing opportunity to learn from the best and to build up my expertise. But it was to be a major investment in time and money, and would mean that I gave up my private hospital work to be at Harley Street. More leaping into the dark.
But, again, I said ‘yes’.
So now I split my time between my clinic in Essex and Harley Street. I am steadily building up both my general practice as well as my aesthetic case load and am looking forward to bringing more services in.
With my Harley Street clinic, I am not only building up experience in more involved aesthetic care, but I am also exploring the developing field of age management, of which the more I learn, the more my interest grows.
I have appointed wonderful people to help me with public relations and get me involved in using social media.
Now, perhaps ironically, with all of my commitments, attending training, meetings and conferences, I have next to no time – but I’m loving every second of it.
What I have realised is that doctors as a group, especially perhaps NHS GPs, do not realise how far one can go with that GMC number.
There are so many areas that we could explore to rekindle that early love and passion we had for our chosen vocation, before we had that enthusiasm beaten out of us with bureaucracy and workload.
Perhaps the only take-home message I have is that if you have the courage to open yourself to opportunity, opportunity somehow seems to find you.
I am so enjoying independent practice and I only wish I had started earlier in my medical life.
Nevertheless, I often wonder what would I do if, in some way, all this turns sour and I was asked to go back to the NHS again.
I’d probably say ‘NO’.
First published in the Independent Practioner Today magazine