An interesting question asked by a consultant who was in the process of starting her own private practice. Also a question I couldn’t really answer.
What I could do however was interrogate, based on an entire month’s worth of outpatient clinic lists for existing MHM clients, how long established private consultant surgeons took for both initial and follow consultations. A number of different specialisms were covered. They included: three orthopaedic surgeons (one feet, one knees, one hands), an ENT surgeon, a gynaecologist, a dermatologist, a GI surgeon and an opthalmogist.
Turning to initial consultations the average time allocated for an initial consultation was 30 mins. Some were under 20 mins; some much longer. But the average time spent at an initial consultation worked out to 30 mins. To further investigate why that amount of time was allocated, I asked each consultant why the outpatient appointment took as long as it did. And got precisely the answer I expected to hear. Some patients required more time with their private consultant to examine, explain and discuss their condition than others. Not one consultant allowed a “maximum” amount of time for the consultation. When asked why, for example, they had allocated the length of time they actually had most made the same comment – it was based on their experience together with recommendations regarding the length of consultations they had received from colleagues they had asked.
To get an understanding of the expectations from private insurance perspective, I asked the same question of the various insurance companies themselves. They too shared the view that 30 minutes was about right. All had no fixed time “allowance” for an initial consultation. Two however were concerned that one consultant only allowed 20 minutes for an initial consultation.
Precisely the same process was followed when the question of follow up consultation length was examined.
Unsurprisingly, the time taken for a follow-up consultation was shorter. In the case of a follow-up consultation, the average time taken was 20 minutes. One consultant allocated just 10 mins; another 30 mins. Yet across the various specialisms, the average was around the 20 minute mark fairly consistently Again, insurance companies were asked the same question regarding follow-up consultations as they were with an initial consultation. Again there was no fixed time “allowance” for a follow-up consultation.
But the question remains for the consultant in the process of setting up her own private practice extremely relevant and here is why…
If she had allowed 60 minutes for a consultation, for example, she would see only two patients per hour. At say £125 per consultation she would charge £250 per hour. But if she allowed 20 minutes per consultation, she could see three patients each hour and thus be able to charge £375 per hour i.e. 50% more (£125/£250) Whilst 60 minutes for a single initial consultation is most likely not required, it is the principle being looked at. The same would prove true of follow-up consultations if the fee were £95 per consultation. Two per hour = £190 whereas three per hour = £285.
Paradoxically, I have a somewhat pragmatic view as I suggested to the consultant just starting her practice. It is highly unlikely she would have so many patients as to require the question to be investigated as we have done here.
No MHM client, I’m very pleased to say, actually cared how long a consultation whether initial or follow-up took. And that is how it should be. They were and are only concerned in providing the best medical care and attention they can.