VENTURING INTO PRIVATE

PRACTICE – FLYING SOLO

Dr John Sharkey Consultant Psychiatrist

Tell ‘em what you’re gonna tell ‘em

• Who am I?

• What do I do now?

• What do I like best about life outside the NHS?

• What is not so good?

• What have I learnt?

• Appraisal and Revalidation

Who am I?

• 47

• Mostly my own teeth

• Married

• Father of 4 (22-18)

• Dual CCST in General Adult and Addiction Psychiatry

• Consultant Psychiatrist Jersey 1998 -2008

• Experience of busy private practice and medicolegal work

• My cunning plan………………….

Optimistic departure from the nest

• Interest in Occupational Psychiatry (Occ Cert)

• Track record in Private Practice

• NI: poorly developed private sector

• Well connected

• Cheaper place to live

• Safety net of return to NHS

Falling from the nest

• Recession

• Protectionism and Occ Docs

• Wrong place to live

• Poor market research

• Hunger?

Taking flight

• No work from Occ Docs

• Private practice population very different from Jersey

• Hunger is a great sauce!

• Medicolegal sector: marketing

What do I do now?

• Medicolegal reports (PI, Med Neg, Criminal, Employment,

RUC pension, family)

• Locums

• Tribunal work in RoI (available in NI if interested)

• GMC work

• Private Practice (currently none but plan to re-develop in

September)

Medicolegal Reports

• Mostly RTA and work injury; mostly plaintiff instructions

• Little work from CIC or VI reports yet

• Most instructions received by email

• Great emphasis on customer care

• Appointments by email using copied template

• Transcription through an agency

• No employees

• Co-director (Mrs S) assists with admin

Typical week

• 2-3 days of patient facing appointments

• Otherwise working from home

• Locums cause time pressure

• Will agree to short-term part-time in places I fancy

Supports

• PIPSIG NI

• Informal networks

• CPD events

What do I like best?

• Flexibility

• Choose my own holidays

• Fewer uncontrollables

• I’m my own manager

• Ability to say no to work I don’t want to do

• Item of service payment

• Feedback from the market

• No boundary issues with public/private split

Not so good?

• Hard to turn down customers

• Can be lonely

• Pay for your own CPD etc

• Dependent on what work comes in (e.g. slack or dull)

• Could be financially insecure

• Receiving payment can be a problem

• APPRAISAL and REVALIDATION

What have I learnt?

• There is loads of work out there

• NHS has many attractive elements (companionship, free

education, paid to drink coffee and chat with colleagues!)

• NHS is well paid. It is quite hard to replace that salary

• I can thrive in the private jungle

• The insecurity is good for performance and BUZZ!

Any comments Madame Piaf?

• Non, je ne regrette rien……….except

• Choice of place to live from perspective of work

• Appraisal and Revalidation are unsatisfactory as the

mechanisms are NHS-centric

Advice to others

• Requires self belief

• Requires support of family

• Do not go independent until adequate experience of the

rough and tumble of life as an NHS consultant for years

• Moral compass: quality of work comes before cash

• Learn to say no

• 7 Habits of Highly Effective People by Stephen Covey

Appraisal and revalidation

• A moving target

• Set up with NHS doctors in mind

• Varying levels of imperfection

• Regional and Sector bias (against NI and independent)

• My own story………………….

Tell ‘em what you just told ‘em

• Psychiatrists can thrive outside the NHS

• Personal freedom is greatly increased

• Good performance is rewarded

• New challenge is invigorating

• Not an easy or risk-free option

• Running a business can be a headache

• There are costs and insecurities

• NHS is our natural habitat but it won’t suit us all!

Comments or Questions please…..

email:

yekrahsj@gmail.com