Adapting to survive

By Robin Stride

Private doctors are re-organising their fee structures and adapting to new ways of working as they struggle to stay afloat during the Covid-19 crisis.

Results of an online survey, by the London Consultants’ Assoc­iation (LCA), reveal frustrated practice owners fear disaster as they have no work, zero income and mounting financial problems.

Some are more upbeat, but others among the 238 specialists who responded to the questionnaire within five days said retirement was their only option.

One in ten had applied for the Coronavirus Business Interruption loan, with just over a third having to furlough support staff.

The LCA said doctors had adapted the way they charged and consulted for their services with eight in ten invoicing for remote/virtual consultations; 86% for consulting by phone, 11% for prescriptions outside consultations and 6%  for queries needing an email or phone response. Self-pay fees are expected to rise. 

Only 5% currently invoiced for often time-lengthy participation in multidisciplinary team meetings.

Eighty per cent had consulting room access restricted or withdrawn, with a similar number having restricted diagnostics access. Nine out of ten had booking and admission difficulties.

Over half (55%) aim to increase remote working, 37% expect to work fewer hours/days, one in four are considering a different employment model and 3% will move to agency secretaries.

The LCA reports in this issue: ‘The majority of the respondents feel unsupported by the private medical insurers, their defence provider, their hospital providers, Government and, in some cases, their NHS employers.’  

Defence providers offered to cut premiums for only 30% of respondents. A further 38% of doctors had approached their provider to get a reduction. 

Private practice was disrupted for many as they backed national efforts, but restoring this to past levels will be challenging, the association reported, particularly for private practice full-timers. 

It said many consultants were seriously considering giving up private practice. But it would focus its activities on supporting them in offering high-quality care. 

For those continuing, operational changes will include more effective IT use for patient and business management, streamlining systems and reducing patient numbers to allow social distancing – meaning fewer patients per unit of time. 

Consultants anticipate working longer hours with lower income and do not expect to return to face-to-face consultations until frequent and reliable Covid-19 testing is available. 

But the LCA warned loss of confidence resulting from the pandemic would continue to influence patient demand for some time to come. 

Now it urgently wants to know what actions can be explored to address the situation and speed up a staged return to normal care for private patients.