How do I find the right PA?

Our Troubleshooters Sue O’Gorman and Hannah Browning tackle an increasingly common question from doctors.

QI am new to private practice and need to get some secretarial support. What do I need to consider and how do I find the right person to support me?

AA practice manager or medical secretary is a highly skilled role. They are critical to your practice and, if you choose the right person or people, they can help your business to grow, keep you compliant and help gain a position reputation with patients and providers.

The decision on choosing your secretarial support should not be rushed. The investment in time in getting it right will hold you in good stead for years to come.

Consideration number 1: The type of support you require

It is important to understand what you would like your support function to incorporate. There are a variety of models as every consultant has differing requests and needs.

The primary areas that would fall under your support function are:

  • Phone answering, appointment booking and diary management;
  • Patient and hospital communication and liaison;
  • Typing;
  • Billing;
  • Marketing and website;
  • Accounts.

This is a very high-level list with multiple functions falling under each category. Each of these functions could be provided by a separate company or you may choose to have them all within one place or as a hybrid.

Consideration number 2: Who to provide the support

The main opportunities that consultants have for accessing support are:

  • NHS secretary;
  • Family member;
  • Doing it yourself;
  • Hospital provision;
  • Employ directly;
  • Group or consortium;
  • Hybrid model.

NHS secretary

This, for many consultants, may feel like a safe option to start off your private practice. Your NHS secretary will have an excellent knowledge of the procedures you offer and understand how you work.

They are often lower cost, as the hours will be flexed around their NHS commitments.

However, your secretary should not be taking your private calls while at work in the NHS. This automatically puts you at a disadvantage, because those initial opportunities and patient calls will not be captured in a timely manner and may be lost.

It is also much harder for hospitals to liaise with a secretary out of hours when their main office hours will be 8am-5pm.

Family member

Having a family member to look after your practice may appear attractive from a financial perspective. However, there are also other, more important considerations:

  • Do they have any experience in managing and running a private practice?
  • Are they able to give it their full attention and be able to take calls/deal with queries throughout the day?
  • What happens if you both go away together?
  • Ensuring you get a break from your practice can be harder if you have a home-based support system.

Do it yourself

There may be some of the support functions that you would like to do yourself and this would be an option to reduce costs until your practice builds.  

But there does need to be an understanding that you are the expert in treating patients and there are others that make it their business to be experts in supporting you.

The balance of your time should also be taken into consideration, as there will come a point where you would be better placed seeing and treating patients that spending time doing your admin.

Hospital provision

Most hospitals will have an in-house secretarial support function. These teams can often offer flexible time packages while ensuring you still have coverage of the phones. 

They also have the advantage of being integrated into the infrastructure of the hospital and therefore the pathways for accessing inquiries, theatre slots and so on should be easier.

This model gets more complex if you would like to work out of more than one location with different providers. Having a secretary in each location is an option, but you would need to understand the flow of inquiries from your marketing and how these will be handled.

Employ directly

For a new consultant, this will feel like a big step because you will be taking on the responsibility of a person’s salary and the associated legal requirements.  

You may also not have the funds to cover a full-time post, but still need the phone coverage.  

Employing a secretary can often work together as a hybrid model until you can commit fully.  

Having a company to answer your phones and book appointments will ensure you capture all opportunities while your secretary can look after your administration.

It may be that you can join with another consultant to spread the cost of employing a secretary. This will give you both phone cover but without the full expense.

Group or consortium

There are a growing number of support function groups available to consultants. They can specialise purely in administration support right through to the full private practice remit, including marketing and accountancy.

Groups have the advantage of offering cover not only for the phones during the day but also for any holidays and sickness. They consist of teams that have their own areas of expertise, all brought together in a single monthly fee.

The types of packages can be flexible enabling you to add hours as your practice grows.

The cost for using a group may be higher than other options; however, you get the added benefit of convenience with all the specialists in one place.

Hybrid model

There are companies that exist to provide every one of the functions listed above. This is the ultimate pick and mix of how to build your support service.  

Keeping a core function with one provider then enhancing these with additional expertise can help you to individualise how your practice is run.

Sue O’Gorman (left) is director of Medici Healthcare Consultancy. Email: 

Hannah Browning (right) is director of Beyond Excellence Healthcare Consultancy. Email: