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Private Practice in a Bag, The Private Practice

By Margaret Faux
. In the 1990s, the spread of computers promised to free up office workers. Without the need for paper, workers would be able to set up their computer wherever there was space.

But it took a decade for “hot desking” to catch on. Today there are professionals from all fields of work who carry on their business lives from cafes, airport lounges, their home or hotel room.

This revolution liberated many professionals from being tied down to a street address but not all of them saw the potential. The medical profession was cautious, and with good reason. Not because medical practice doesn’t lend itself to such flexibility, but because doctors are reluctant to do anything that might compromise patient comfort and security.

We have been trained to think traditionally about the delivery of medical services. However, in the digital age, flexibility comes in many shapes and forms. Imagine the following scene: you walk into an essentially empty room, with an examination bed, a desk and a chair. You unpack your medical bag and go to the door to invite your first appointment in. After seeing all your patients for the day, you pack up your bag and head out. No shingle, no receptionist, no overheads.

Up till now, this scenario is not how doctors have traditionally carried out their clinic work. But it is starting to be used by doctors as a way of providing specialist attention, where it is needed, without being tied down by the trappings of private practice.

Though doctors carry their skills with them wherever they go, the business of seeing patients is increasingly weighed down by maintaining rooms and staff, and processing copious paperwork. It’s an expensive burden and, for many, an impediment to good practice.

Thinking outside the square

However, some doctors are starting to think a bit differently. One NSW rehabilitation specialist has negotiated with a private hospital to use one of their rooms when it is vacant at certain times. He is primarily based at two other hospitals and this arrangement allows him to see patients in a third locality. He turns up one day a week to see his patients.

There is no receptionist to ‘meet and greet’ those on his appointments list. He brings a portable merchant facility with him to swipe credit cards for payment. A laptop and printer allow him to print off the receipt. His “rooms” are in his bag.

Another doctor in Queensland, a neurologist, does most of his work in the public system but sees a few private patients. It also suits him to “borrow” space to see these patients so he does not have to set up his own rooms. He doesn’t need to invest in expensive diagnostic imaging equipment because he can always refer patients on to have tests at the hospital.

Of course, this type of approach is best suited to specialisations that don’t need a lot of equipment. It may be a matter of carrying around a patella hammer and a stethoscope in the bag.

Working this way is particularly attractive for doctors at either end of their careers. For those starting out, it means being able to set up in practice without an enormous capital outlay and heavy on-going costs. These can cover everything from taking out a lease on premises, hardware, software, staff salaries and so on. But for a few hundred dollars a week, a new graduate specialist can now be up and running, and seeing patients.

Likewise, specialists who are winding back before retirement do not want to take on the commitment of new staff and update office equipment just so they can keep a part time practice viable.

The ability to simply use a room or rent sessional suites in a private clinic is predicated on being able to outsource the administrative tasks associated with private practice. In the main, these tasks are:

Many doctors are already outsourcing one or more of these functions, either permanently or on an ad hoc basis, to cover staff absences and supplement capacity during busy periods. For some group practices overheads can be kept low by employing fewer staff to meet and greet patients and tend the phones, while the billing and typing can be outsourced.

By outsourcing these non-core tasks, doctors are able to concentrate on the real issue at hand – patient care. And because administration is being left to companies that specialise in these areas, the jobs are handled professionally and cost effectively. It’s actually cheaper to move these burdens out of the clinic.

It can also help doctors see how to run their practice more efficiently by highlighting what their core needs are, how they can be best addressed and who is needed to fulfill them.

There are benefits for patients, too. Apart from reducing the costs which ultimately must be passed on to patients, appointments scheduling empowers patients to organise their visits to the doctor. Instead of a to-ing and fro-ing between patient and receptionist, trying to find a time that suits both, a patient can sit down and see all the vacancies and consult with family members about a suitable timing. All this can be done out of clinic hours at the patient’s leisure.

A medical consultation is an intimate and personal exchange between doctor and patient. The two people in the room are essential to the interaction: the doctor brings their experience and knowledge to bear on diagnosing and treating the patient’s condition. The rest is extraneous.

Margaret Faux is the Managing Director at Synapse Medical Services Pty Limited. Synapse Medical Services provides a comprehensive range of administrative outsourcing services for specialist practitioners. You can read more of Margaret’s articles under Publications.

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