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Is successful private practice in the UK possible?

Discussion in 'United Kingdom' started by davidh, Jul 25, 2012.

  1. davidh

    davidh Podiatry Arena Veteran


    Members do not see these Ads. Sign Up.
    As the title really.

    Is it possible to have a viable private practice in the UK?

    I cotend that it is. I have been in constant PP since I qualified, apart from a brief spell as a full-time NHS drone in the early 90's. That paid for one degree and gave me time off for another so can't complain about that.

    My current practice is viable, if small. I live in a very remote part of Wales with a low population (12 sheep to every person:D). I only moved here two years ago.

    How do I do that?
     
  2. R.E.G

    R.E.G Active Member

    David good question 'how do you do that.

    Just a quick search Powys has a population of 133,000 people and Yellow pages shows 18 pod practices.

    Are you Orthopod Clinic Ltd Buith Wells?

    Seems you break all of your advice.

    A few guesses, you still have your BUPA work, you have a slimming company, you released capital when you relocated to Wales.

    Just how small is your practice ie, clients per week, cost for basic chiropody, (or do you not do that), home visits etc.

    My practice was large enough, it has shrunk with the recession, it is viable, if I was young and trying to support a family on my earnings we would be on income support.

    As others have pointed out general practice is tough, niche markets are possible but I have seen many 'great bios' revert to corn cutting.

    I do not know the answer I do know that I am the worst salesperson I know, guess I just do not have that gene.

    So please tell us how do you do it?

    Bob
     
  3. betafeet

    betafeet Active Member

    Overheads of running a business are crippling, so much time spent marketing and putting protocols in place. It’s very tough out there I would say I put as much time into practice management as I do doing the job. If I spread that out I would say I’m working near on a hundred hours per week, so money paid for time invested - not good.

    But I am proud of what I have achieved and don't want to give that up so I will keep plodding away.

    Jude
     
  4. davidh

    davidh Podiatry Arena Veteran

    Bob,

    We have 2000 population and one chiropodist where I live.

    I looked at opening a small practice in Brecon (10,000 pop in and around), but two chiropodists already there so that was a no-go).

    I adapted my work to fit the circumstances.
    I have practicing rights at four private hospitals, but only pay for when I'm actually there.
    They hold my diaries and make appointments.
    I do mostly biomech, but that has been devalued (I won't mention the group responsible) and orthopods no longer refer work in, in my area at any rate.
    The evidence I have (from medico-legal sources) is that this is not confined to the Midlands, and some orthopods believe that patients should pay no more than £150 for a pair of orthotics.

    I charge a consultation fee of £125.00. I don't do chiropody. I do see some patients who I refer on for chiropody though.

    I have found some work which I can do from home which allows me freedom through the day if I choose. I'm an accredited Expert Witness (Podiatry) with APIL (Association of Personal Injury Lawyers). Training is ongoing, but I did the important stuff last year.
    Some clients I have to see, some I just get sent the paperwork.
    My practice is growing nicely.

    In short, I adapted to the prevailing conditions.

    You mentioned Scholls as not succeeding on the other thread. Good example, but they only stopped succeeding because they did not change their business plan to match the market. In the 50's and 60's Scholls were highly successful. In Sunderland there were two Scholl "shops" in one street - both very, very busy. I know because my father was manager of one.
     
  5. R.E.G

    R.E.G Active Member

    David you have obviously done well, your strategy of diversification is to be applauded.

    I have had multiple careers none of which have failed but when circumstances became adverse I moved.

    I now like you have many fingers in many pies, and would consider myself ‘successful’.

    However if I was newly out of Pod school with student debts, no capital or business acumen could I assemble a good enough business plan to convince a bank to back me?

    So let me change the question from ‘is successful private practice in the UK possible’ to ‘can private practice achieve a higher than average graduate starting salary (£26k) (www.studentbeans.com) then try www.totaljobs.com for 5 years on.

    So it seems to me get it right and you can probably beat the odds, but you have to be a good businessperson.

    Unfortunately in the present climate I would suggest you work very hard, if you are lucky, for a very uncertain reward.

    Ps I will have a very pleasant practice for sale in the near future.

    Bob
     
  6. davidh

    davidh Podiatry Arena Veteran

    the short answer is no.
    With a caveat - if one is prepared to work at development, using the pod degree as a first degree stepping-stone it is perfectly possible within 10 years to be making much more than the average graduate.

    Graduates from Oxford, Cambridge, Durham and Newcastle and other high calibre Uni's will have no difficulty in finding jobs. Graduates from lesser Universities do often tend to struggle to find work.

    Back to Pod - there are. as you know, many areas to develop after the first degree.
    With a 2.1 or above you can gain entry onto a Medical or Law Course, or do a higher degree in a better Uni.
    With a 2.2 it is still possible to access a higher degree. An MSc in Surgery would be the obvious choice.

    A C.Ped course is also worth considering.

    Expert Witness work is for the very old:D.

    Professional quals do not have to stop after the first degree.
     
  7. R.E.G

    R.E.G Active Member

    David

    You are now confusing me.

    Are we now talking about what opportunities a pod degree opens up rather than making a living practicing Podiatry?
     
  8. davidh

    davidh Podiatry Arena Veteran

    Yes. We agree the marketplace has changed. We have to change with it.
    A private practice needs to be able to deliver whatever is needed, not necessarily in high volume, which used to be the case, but certainly in terms of high quality care.

    So the emphasis may need to shift from, say, corn-cutting to biomech or more surgery, or bone surgery. It's really whatever fits the situation. The opportunities the pod degree opens up are fall-back positions. We didn't have this in the old days with the diploma. Then it was sink or swim.
    It really isn't like that now.
     
  9. I have been in private practice for over 17 years and this year is my worst ever, Age Concern has taken over a quarter of my home visiting older persons, my residential homes dwindled from 15 to 2 as I have been undercut and won't do discounts for £10 per patient as others are doing its crazy!

    I have an MSc in Podiatry, apply for NHS and private jobs (part time) with no luck....
    But I love what I do and won't and cannot give up as I have invested so much time and money in my training, what else can I do?
    The recession here in Wales is crippling me and I get no support from anyone.
    How do others survive on tiny incomes?
     
  10. Catfoot

    Catfoot Well-Known Member

    Hello again Tracy,
    I have only just seen this posting, so apologies for that.

    When I read your posting on the other "Age Concern" thread I thought that you were a new graduate who was having a hard time getting a foothold in the market, not an established practitioner.

    You say in this post that
    From what you have said Age Concern (or AgeUK as it is now)are providing a cheap/free nail-cutting service - but this is not Chiropody/Podiatry. So why are they "taking over" your patients? Surely your service wasn't just purely nail-cutting? How do these patients now obtain treatment for their podiatry needs?

    Perhaps you can expand on what you have said, as I don't fully understand what the problem is.

    regards

    Catfoot
     
  11. davidh

    davidh Podiatry Arena Veteran

    On another thread George Brandy suggests that SCP Branches have the answer to building up a successful practice, thus making this thread redundant:rolleyes:.
     
  12. With regards to podiatry needs, my patients the older ones don't give a hoot about my training they just want their nails and corns dealt with. All the educational advice I give or other therapeutics are not heeded or required purely on a cost level. I cannot change the majority of my business base as after all that has been making my living for nearly 20 years. I am trying to branch out in another area to change the age range and structure of footcare range.

    Just wonder wrong how others are riding the downturn?
     
  13. Ian Linane

    Ian Linane Well-Known Member

    I don't think there is any easy answer to the, at times, struggle of business. I do think it is worth looking at what additional podiatry skills you could acquire for PP that gives you that distinctive edge or provides for a patient care which can also earn you money. Appropriate Up-skilling is probably more a necessity in todays market than a luxury, especially if you are thinking long terms presence in the market.
     
  14. fishpod

    fishpod Well-Known Member

    excellent question.
    podiatry is i believe taking a real battering at the moment.as a buisiness start up the market is flooded with graduates who cannot find nhs work plus all the other fhp type competition. [plus the recesssion. i personally have done extremly well out of podiatry but even now things are changing contracts are more difficult to renew things are uncertain. the last 17 years have been amazing ime not sure the next 17 will be as good.

    most private practices dont return high incomes yes i know some do but these are the minority . at branch meetings people say oh im part time i dont do it for the money bloody hell i do. so there are lots of self employed pods eanring bugger all really.
    then theres the nhs . if you are the best of the best top gun with an msc you are a band 7 start on 30 grand finish on 40 takes 9 years so in reallity you have spent half your life as a band 6 earning on average 29 grand a year . it does not make pleasant reading unless you think 40 grand is good renumeration for someone at the top of their game.

    is it no wonder pod schools are full of mature students who have already failed in their previous lives. who would give up a successful career for aband 5 job if you are lucky earning 25 grand or the oportunity to be self employed eanring rubbish money.

    its hard to see it coming i wish i had a crystal ball.

    before all you rich pods me included tell them there are lots of us i dont believe there are an most pods are struggling to make ends meet. we are doing well for the moment what will tommorrow bring perhaps tracys tale i hope not
     
    Last edited: Aug 16, 2012
  15. Catfoot

    Catfoot Well-Known Member

    David H,
    When you said


    You were funny :D


    regards

    Catfoot
     
  16. Jonix

    Jonix Active Member

    :sinking:I read this and I feel depressed now.

    And I am too old and too ugly to marry money!!
     
  17. Jonix

    Jonix Active Member

    Seriously though, the profession does itself no favours with part-time private practitioners tucked at the back of chemist shops, beauty salons and hairdressers. No wonder people do not value us full-timers as professionals who need to charge enough to cover rent, holidays, CPD and sickness and etc etc etc! It has been my goal all along to be good enough at my job to justify my fee, which is quite a bit higher than some in my area.

    The recession was just one in a string of potentially terminal problems I survived. Somehow I am still here. But it is true.. I show no signs of becoming rich or even comfortable! As others have pointed out, the work rewarding, and I would be selling my soul if I worked for money alone.. Does that sound defeatist?
     
  18. davidh

    davidh Podiatry Arena Veteran

    It does to me Jo - sorry.

    If you're happy to be in your current position, fine. Enjoy what you have.
    The part-timers aren't the problem BTW. The problem is a saturated market for ordinary chiropody.
     
  19. Mona_J

    Mona_J Member

    I'm also interested in this issue. I'm currently a teacher who's struggling to find full-time work and barely staying afloat financially by working part-time as a supply teacher. I want to change careers to something with more opportunities and more money, and the careers adviser at the university has led me to believe that if I retrain it should be possible to make a decent income (in the £30-50k bracket) as a self-employed podiatrist.

    Is this bad advice? Would it be a bad decision to embark upon a podiatry degree with the aim of starting a new (better paid) career? Or are there decent prospects for a new podiatry graduate to become self employed? I'm interested in feedback from current practitioners about how much money I could earn and whether it's worth retraining.
     
  20. davidh

    davidh Podiatry Arena Veteran

    Hi Mona-J,
    Check the various threads on here for more info.
    I think the careers advisor needs to retrain;).

    If you go into the ordinary chiropody marketplace, which is what most people do on qualifying you will find very crowded. The prospects are not good.
     
  21. Mona_J

    Mona_J Member

    Really? The institution in question advertises that 100% of graduates from the podiatry course are in paid employment within 12 months of graduating, and that private practice salaries can approach £40k if you work more or less full time. So podiatry seemed like a good option, especially because you don't have to pay fees (I had a student loan for my first degree and can't get another one).

    If the job prospects are truly as poor as you say, then I'll have to carefully consider other career options instead, which is a shame as I thought that podiatry would be really interesting and I could make a difference to people's quality of life.
     
  22. davidh

    davidh Podiatry Arena Veteran

    What is the Institution? Is a Uni really telling people this?

    In the old days this was probably the case, but no longer.

    Look - do your own analysis.
    Look at how many patients you think you will see straight after qualifying.
    Look at the cost of renting a surgery (or even a room), fitting it out, cost of equipment - at least a patients chair, an operators chair, a unit, a drill, an autoclave, and instrument sets. Then add in your mandatory Continuing Professional Development, personal indemnity insurance, and other insurances you may need (like if you are off sick). Finally membership of the HCPC - you don't have any choice in this, will cost you £140 smackers every two years.
     
  23. Mona_J

    Mona_J Member

    I told the careers adviser I wanted to switch careers to something with a high employment rate and low fees (because I can't get another student loan), preferably something which utilises my scientific and technical background and has prospects for self employment. She suggested podiatry because the fees are paid by the NHS and employment prospects are excellent, and also there are opportunities for further professional training and career progression.

    Here are two links to courses I'm considering. Both of them clearly state that employment prospects are excellent, with 100% of graduates in employment within 6-12 months. The latter link suggests that salaries can eventually reach £97,000. It seems extremely unfair if these institutions are lying to prospective students in order to get bums on seats.

    http://www.hud.ac.uk/courses/2012-13/part-time/undergraduate/podiatry-bsc-hons/

    http://www.brighton.ac.uk/sohp/prospective/podiatry/become/whypodiatry.php
     
  24. Jonix

    Jonix Active Member

    WOW! Challenge the careers advisor and the university to produce figures!

    You can turn over 40K, but there is a big difference between that and "earning" 40K. (Have you calculated how many patients you have to see just to turn over 40k?? They don't come out of the woodwork!) I don't agree that the prospects are "poor", its just that in private practice there are, as has been mentioned, a whole bunch of up-front costs (which do not apply if you go and work in an established pratice on a fee-share basis), as well as significant on-going ones..

    Depending on your business structure, you don't make a penny till these costs are covered. If you set up from scratch, allow at least a year before you make any money whatsoever, let alone enough to live on.

    Unless things have changed (and I don't think they have) you tend not to be that well trained in business as an undergrad, so you will quickly find out if you have an aptitude for it, as well as an aptitude for working as a therapist. As has been implied throughout this thread, the qualities that make good therapists don't necessarily make good business owners.

    Personally, I got hit with a series of disasters - which hopefully a relocation will sort out - but relocating in itself is a huge financial set back. You do have to assume you will meet with some disasters, and be prepared to stick with it - unless you are extremely lucky or extremely thorough in your planning. Hence many businesses don't survive the first year.

    So frankly, I don't think you have been advised well.

    However, should you decide to go ahead anyway; well that would suggest to me that you might have what it takes to make a go of it !!

    Good luck with your decisions.
     
  25. davidh

    davidh Podiatry Arena Veteran

    And tell us who the Institution is;)!
     
  26. Mona_J

    Mona_J Member

  27. David Smith

    David Smith Well-Known Member

    Fishpod

    Please put some punctuation and grammar in your writing, I don't know if you are complaining or boasting or what point you are trying to make!?:confused:

    Dave
     
  28. davidh

    davidh Podiatry Arena Veteran

    You did, and I missed it.

    I'll follow up on these. If they are doing as you suggest it is not only unfair but misrepresentation (at best) and fraudulent (at worst). Thanks for flagging up.

    Update.
    Huddersfield say in their prospectus that 93% of their graduates found work within 6 months of qualifying - in 2009.
    Which could be true. They don't give figures for 2010 or 2011,

    Brighton make no claims for employment in their prospectus as far as I can see.
     
  29. victoriah

    victoriah Active Member

    I graduated from Brighton some years ago, and they have never made any attempt to contact me about my employment status...I could be rolling in money, or languishing on the dole for all they know.

    I do recall that most of us got something of a shock upon graduating. The university had never once mentioned the "issue" of competing with FHPs as a private practitioner. A large percentage of us felt somewhat misled, and certainly unprepared for the reality of the job.
     
  30. fishpod

    fishpod Well-Known Member

    reply to dave smith. not boasting just saying things are difficult at the moment and even for those of us who are doing ok its constantly changing. and as for you mona if you had a copy of our latest podiatry now magazine not a single nhs job in the jobs section. they have been blowing smoke up your ass because they want to keep thier low paid teaching jobs cos no students no job .they will tell u anything your chance of earning 40 grand from birmingham to scotland bugger all 50 grand you are on drugs. i could not comment on down south as the economy is different down there as well as living costs.
     
  31. blinda

    blinda MVP

    Darn Sarf, the picture aint too grand either. As fishpod said, living costs are high here and patients are thinking twice about where they spend their pennies and are demanding more from their choice. Small businesses in general are sufferring greatly, particularly those who offer products/services similar to larger and well established companies.

    That said, if you mantain a high standard of care and advertise your USP (unique selling point) amongst the public and other health care providers, your professional reputation can still attract new patients by personal recommendation.

    This week is relatively quiet in comparison to this time last year. Next week is looking better and the week after I`m fully booked. Go figure. Speaking to other private practitioners, they are also experiencing slow periods, yet it picks up again. Guess the uncertainty of the recession is hitting us all.
     
  32. David Smith

    David Smith Well-Known Member

    Yes of course it is!! I know many who make a very reasonable living from PPP.
    Personally, I have a sign on the front door that says 'no riff raff or penniless ragamuffins'. No really, each day I have to beat them away with a stick in the morning. Really its like new years sale day at Harrods some mornings here. I've had to move to a bigger house coz the spare room was full of cash and I need more storage space for the twenties and fifties. I'm taking George Osbourne and Guy Laurence (Vodaphone CEO) out to lunch next week to discuss with the head of HMRC the mistake he's made about my outstanding income tax cash, a large lump of which is mostly still on holiday in the Cayman Islands.

    I work at least 3 days per week with 2 hours for lunch and on the golf course by 4.oopm most days. I employ Lithuanian orphans to do the menial chiropody work like cutting nails and corns, 40p an hour and all the beans they can eat (its the biz.gov new Modern Apprenticship incentive scheme you know). I have a conveyor belt system for the working class customers, they come in at one end and it's cut, grind, polish, slash, buff, bandage, pay up and stop your mithering, good day see you in 6 weeks, thankyou! as they're politely shoved out the back door into tradesmen alley, 'mind the puddle' NEXT!

    And for the finer class of client we have the tongue in butt, smarmy pandering, top of the range Podiatry service with ego inflating chit chat and wallet busting fees to make them feel special (which they love).

    Really, life as a podiatrist is just one long round of Golf, parties, cocktails and luxury holidays and the rest of the time is my own 'me time'.

    Aaah! it's almost like work :eek:

    Regards Dave PS I'm opening in Wales Next!! :D:D:D Just in case the HCPC think I'm being serious
     
    Last edited: Sep 27, 2012
  33. fishpod

    fishpod Well-Known Member

    life as a podiatrist is just one long round of golf', parties, coctails and luxury holidays. bloody hell dave dont give our secrets away they will all want some . ill think of you in november when ime at the longboat key golf and beach club sinking a margeritta watching the sun disapear into the ocean. chillin will be a challenge but ime up for it.all the best fishpod.nb i employ romanians they come cheaper and eat less.
     
  34. David Smith

    David Smith Well-Known Member

    Is that Dibden Affiliation of Rascals and Ninnies - the Southampton And Ringwood Fellowship?

    And should'nt you have been more grammatically correct using the more colloquial phrase - it ain't to grand darn ere neiver. adding "guv'nr" for a more working class feel ( I like a working class feel :))

    Luv Dave;) or are you one of the Dedicated And Righteous of Netley?
     
  35. blinda

    blinda MVP

    An absolute must to be successful in PPPPPPP. ;)

    Mmm. Me too.
     
  36. Just wish I was a couple of years younger and emigrated to Australia, so much for all the hard training and getting not a lot in return... Anyway struggle on or give up.... I just don't do giving up thou !!!
     
  37. Good post Dave - made me smile. I guess to answer Dave's qestion, it depends on how you define "success". There's little doubt that private practice is challenging financially in present times - for a variety of reasons. But you can still make a reasonable living from podiatry, providing you offer good, effective care - along with everything else that defines professionalism; kindness, empathy, sympathy etc. But success can also be measured in other ways - the respect you command from your patients and other health professionals - and how you feel, personally, from the care you deliver to those that seek your skills.

    Remuneration is important - but to have that as the only goal of your practice neglects the other real benefits that being a member of this profession has to offer.
     
  38. twirly

    twirly Well-Known Member

    Only ever wanted to complete my chosen degree. Pay my student loan off (took 10 years). All done now thankfully. So long as I can pay whatsoever windowed letter comes through the letter box all is good. Any extra is a bonus. My reality is what many others in this country would love to have. Not smug, just grateful. I worked & work hard for this living. Those spouting about 40 patients a day want a reality check & daftness you can keep. Quite happy not advertising & making a crust. Never studied to be a millionaire, just like what I do without thinking I'm over egging the pudding.

    This is not a competition, this is life. My life is just grand. I clip nails & sometimes I remove nails. I will not change the world or do I want to. I leave that to those who actually have the ability to use punctuation & do not post just to state how much more smug they are. That is just sad. I post less now as I feel so disheartened by those who have railroaded a great web-site with pointless bun fights. Talk sense or for the sake of whosoever you believe in get a life. ...Mandy. PS. If you feel incensed enough to respond to this post it is obviously aimed at you!
     
  39. Andrew Ayres

    Andrew Ayres Active Member

    Update.
    Huddersfield say in their prospectus that 93% of their graduates found work within 6 months of qualifying - in 2009.
    Which could be true. They don't give figures for 2010 or 2011,

    Brighton make no claims for employment in their prospectus as far as I can see.[/QUOTE]

    This does not say how they were employed. I worked in the local Co-op for a week or 2 after graduating therefore I would have been classed as having found work. Some one who is self-employed with a patient base of 3 will also be classed as having found work. The question that needs to be asked is how many found meaningful work as a podiatrist?
     
  40. R.E.G

    R.E.G Active Member

    Twirly,

    The title of the thread is 'is successful private practice in the UK possible'.

    Fair enough you have described your definition of success as 'covering the bills'.

    With respect that would not define success for me. However if it ticks your boxes OK, most of us (I think) would expect a reasonable salary for our efforts. What that salary is may be an interesting question.

    The rest of your post however I find derogatory, and totally off thread. I, like you, have become disheartened with this web site, but probably would disagree with you who the authors of the 'pointless bun fights' are. I would start by checking your 'thankers'.

    ps. not 'incensed enough to reply' just disappointed by your naivety and arrogance.

    Andy A excellent post, this question was asked at a SCP delegates conference a few years ago and no answer was available. There are interesting discussions on this site about Pod training, jobs and the future but all IMO too far in the future.

    Now IMO times are tough and getting tougher. I believe that Pods need to work together but doubt that that will happen, far too much unproductive competition?

    Had my say so bye

    Bob
     
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