Presentation from the International Congress of the Royal College of Psychiatrists 24-27 June 2014, London

1. VENTURING INTO PRIVATE
PRACTICE – FLYING SOLO
Dr John Sharkey
Consultant Psychiatrist

2. Tell ‘em what you’re gonna tell ‘em
• Who am I?
• What do I do now?
• What do I like best about life outside the NHS?
• What is not so good?
• What have I learnt?
• Appraisal and Revalidation

3. Who am I?
• 47
• Mostly my own teeth
• Married
• Father of 4 (22-18)
• Dual CCST in General Adult and Addiction Psychiatry
• Consultant Psychiatrist Jersey 1998 -2008
• Experience of busy private practice and medicolegal work
• My cunning plan………………….

4. Optimistic departure from the nest
• Interest in Occupational Psychiatry (Occ Cert)
• Track record in Private Practice
• NI: poorly developed private sector
• Well connected
• Cheaper place to live
• Safety net of return to NHS

5. Falling from the nest
• Recession
• Protectionism and Occ Docs
• Wrong place to live
• Poor market research
• Hunger?

6. Taking flight
• No work from Occ Docs
• Private practice population very different from Jersey
• Hunger is a great sauce!
• Medicolegal sector: marketing

7. What do I do now?
• Medicolegal reports (PI, Med Neg, Criminal, Employment,
RUC pension, family)
• Locums
• Tribunal work in RoI (available in NI if interested)
• GMC work
• Private Practice (currently none but plan to re-develop in
September)

8. Medicolegal Reports
• Mostly RTA and work injury; mostly plaintiff instructions
• Little work from CIC or VI reports yet
• Most instructions received by email
• Great emphasis on customer care
• Appointments by email using copied template
• Transcription through an agency
• No employees
• Co-director (Mrs S) assists with admin

9. Typical week
• 2-3 days of patient facing appointments
• Otherwise working from home
• Locums cause time pressure
• Will agree to short-term part-time in places I fancy

10. Supports
• PIPSIG NI
• Informal networks
• CPD events

11. What do I like best?
• Flexibility
• Choose my own holidays
• Fewer uncontrollables
• I’m my own manager
• Ability to say no to work I don’t want to do
• Item of service payment
• Feedback from the market
• No boundary issues with public/private split

12. Not so good?
• Hard to turn down customers
• Can be lonely
• Pay for your own CPD etc
• Dependent on what work comes in (e.g. slack or dull)
• Could be financially insecure
• Receiving payment can be a problem
• APPRAISAL and REVALIDATION

13. What have I learnt?
• There is loads of work out there
• NHS has many attractive elements (companionship, free
education, paid to drink coffee and chat with colleagues!)
• NHS is well paid. It is quite hard to replace that salary
• I can thrive in the private jungle
• The insecurity is good for performance and BUZZ!

14. Any comments Madame Piaf?
• Non, je ne regrette rien……….except
• Choice of place to live from perspective of work
• Appraisal and Revalidation are unsatisfactory as the
mechanisms are NHS-centric

15. Advice to others
• Requires self belief
• Requires support of family
• Do not go independent until adequate experience of the
rough and tumble of life as an NHS consultant for years
• Moral compass: quality of work comes before cash
• Learn to say no
• 7 Habits of Highly Effective People by Stephen Covey

16. Appraisal and revalidation
• A moving target
• Set up with NHS doctors in mind
• Varying levels of imperfection
• Regional and Sector bias (against NI and independent)
• My own story………………….

17. Tell ‘em what you just told ‘em
• Psychiatrists can thrive outside the NHS
• Personal freedom is greatly increased
• Good performance is rewarded
• New challenge is invigorating
• Not an easy or risk-free option
• Running a business can be a headache
• There are costs and insecurities
• NHS is our natural habitat but it won’t suit us all!

18. Comments or Questions please…..
email:
yekrahsj@gmail.com