It is also obviously true that no two services are the same in both the public and private sectors. Doctors have a responsibility to strive for excellence; and if we can inspire others then we are improving the lives of everyone around us.
The development of independent private GP services is not unique to the UK. Both NHS and private GP services have undergone continuous change over the years and most current practices resemble individual businesses. What distinguishes these is who is paying the fees.
The advent of private GP services evolved from the classic Harley Street doctor. Private practices would attract patients into town to be seen by their private specialist or GP. In the early days, this was probably the choice of the very wealthy and international patients. With time, the right to choose has become more enshrined and although the UK has a socialised health care model that offers free care at the point use, this still gives people a choice as to where they go for their care.
I often hear that patients have tried to get authorisations for specialist referrals through their private medical insurance schemes and are advised that they need an NHS GP referral to progress it. This obviously infringes their rights and, as I like to say, “we have a socialised and not a socialist care system”.
The growth of independent providers with several large and some smaller independent hospital groups, together with large insurance companies such as Bupa and Axa PPP, has radically changed the mindset of the public who are generally time-poor and cash-sufficient. This has created an acceptance to indulge in a market that enables faster access to care and on the user’s terms. The days of patients sitting for hours in GP surgeries is in the past and today’s patients want a service that will get them seen, heard and treated on time so they can get on with their lives quickly.
Systems that have been fast to adapt to new technology have done far better than those that lag behind. People have embraced technology and even my 100-year-old patients have an iPad and know how to email.
Sometimes the choice of a private GP is because someone may have difficult veins and is traumatised by the number of attempts at phlebotomy in the past. Some doctors are excellent at taking blood. This element alone is enough to encourage patient choice.
Many private GP services offer detailed physical examinations. Often the results are the same when a patient is given the same information by a private GP as by an NHS GP. What is interesting is that, in having the time to explain a medical intervention, where a person has benefited from a more informed conversation they will take the advice more readily.
Private practices generally have invested in state-of-the-art systems, infrastructure, machinery and equipment. Devices such as fractionated exhaled nitric oxide are standard kit in asthma management. This undoubtedly influences care when one does have the machinery to manage conditions according to Nice guidelines.
Working in close proximity to diagnostics and having immediate access to private consultants speeds up the time needed for appointments and investigations. When one is in a crisis, this is extremely important.
It is often the criticism of private practices that they see only patients with straightforward diagnoses. However, it is my experience that independent services attract the more complex work because patients need time to be heard by their doctor who has known them for many years.
When one has a ten-minute consultations, you get a ten-minute problem. But when patients have a half hour, the doctor gets to spend time and achieves more. It is not fair to expect that a doctor can assess, diagnose, investigate and treat a potentially serious problem in ten minutes. Patients seek out doctors who provide an excellent service with care and attention to detail.
The results, of course, are happy patients but more importantly for the longevity of the service, happier doctors.
Dr Walter Abelman is the medical director of JDoc Medical Ltd. JDoc365 offers private GP services and is based in the Wellington Diagnostic Centre, Golders Green.
See www.jdoc365.co.uk or call 0203 656 5657