About my practice
A private medical practitioner – to be or not to be?
“……..particularly the economics of your private practice would be of great interest to our readers” was the brief given to me when asked to write a short practice profile.
It is generally assumed that doctors go into private practice in order to earn lots of money. Fine, if you are an NHS Consultant with a long NHS waiting list which patients can jump courtesy of BUPA. These economics do not apply to the single GP living in rural Wales where, let's face it, the local people are very careful with their money, trying to compete with the local medical service where consultations are free, prescriptions are free and referrals to the hospital are also free. No, economics is not the reason why I have ended up in private practice. Indeed, I have to say I am very bad at economics – I know I have enough money to give myself a very adequate lifestyle and see my two daughters through university. I have no savings, no pension plan and no intention to retire because I enjoy my work. For me not to work would be the death knell. This style of medicine suits me. However, I would not advise any young doctor to tread the path I have trod unless they have very good reason. It is fraught with insecurity, lack of support and of course very poor holiday entitlement. Furthermore, other doctors who do not understand my style of practice regularly complain about me to the GMC and although none of these complaints has come to anything, simply answering their numerous queries is tiresome.
The only reason I can see for a General Practice grade doctor to go into private practice is for clinical freedoms. I have worked for 20 years within the NHS in General Practice and increasingly found myself restricted by what I was and was not allowed to do. Having recently spent six months as an Associate Specialist at the Royal Shrewsbury Hospital working with patients with chronic fatigue syndrome, these restrictions have become so great that I am simply unable to practise there. All that one is allowed to do for patients is that which is “evidence based” and that evidence base certainly does not include one’s own years of experience. This means that one ends up serving two masters. Firstly the PCT who dictate what is and is not allowed and secondly one’s own conscience. Indeed, the first rule for good conduct by the General Medical Council is “To make the care of your patient your first concern”. That is to say doctors should be patients’ advocates, fighting as hard as they possibly can for what they believe is the best treatment for each patient. Instead, many doctors have become what I call “defenders of the faith”. The big problem being that the “faith” is laid down by Big Pharma who manipulate drug trials in order to give favourable outcomes (gosh, when I dictated that originally it came out as incomes! Actually either would do!). As a result of which medicine today no longer follows a logical and independent science base. Indeed, the current system of post graduate medical teaching is akin to mothers learning about nutrition from advertisement hoardings posted by the food industry.
I believe modern Western Medicine has lost touch with patients. What patients actually want is an answer to the question why they have developed their particular problem followed by which nutritional, lifestyle or environmental changing factors need they put in place to allow improvements. In pursuing this object, I have become the Secretary of the British Society for Ecological Medicine, a medical organisation in which we have our own scientific journal, our own bi-annual scientific meetings at the Royal College of General Practitioners as well as running training meetings for GPs and Consultants. All the medicine that we practise has an excellent evidence base, but of course not the mega financial resources to sell this to the health industry in this country.
So my practice of medicine has evolved from an entirely conventional training at the Middlesex Hospital, London qualifying in 1981 to something very different. Now the focus of my practice is on looking for causes of problems with respect to diet, micronutrient status, allergies and lifestyle changes. This approach is highly successful at tackling the majority of medical problems. Indeed, if this package was applied across the board, then the pattern of chronic disease, degeneration and cancer in Western nations would undergo a radical change.
I started applying these techniques during the 1980s in Annesley Woodhouse in Nottingham, where I was working in a mining community. Within a few years I had interest from friends and relations of my NHS patients and as a result a small private practice evolved. A move to mid-Wales scuppered all this and I spent a further ten years in general practice, working in a rural farming community. However, the same evolution occurred. Within a few years friends and relatives of my NHS patients again wished to consult and after ten years I had so much private work that I was able to give up all my NHS work. I am now in the position where I have a six month waiting list for new patients. Many of these patients are referred to me by their GPs and Consultants and increasingly are funded by their Primary Care Trust.
The majority of GPs with whom I come in contact are receptive to my ideas and suggestions and support their patient in the difficult lifestyle changes I am often asking them to make. Some are not. The two things I dislike most about the medical profession are their power to access diagnostic tests and their power to prescribe. For the person who ends up with a postcode lottery of a GP or practice who are unhelpful, then the patient is completely disempowered by their inability to help themselves. Therefore it was for this reason that I set up a website to educate those people who could not get access to doctors with an interest in Ecological Medicine.
The first thing this website does is to provide everybody with access to as much as I know about Ecological Medicine. It gives details of exactly how I treat various conditions, the sort of diets that I use and the lifestyle changes that I recommend and the micronutrient supplements to take in order that they can sort out their own medical problem. I have a great number of very happy e-mails and letters back from people who have sorted out their medical problems themselves by using this information resource. Because the treatments are with micronutrients they are non-toxic, freely available and of course effective.
The second way in which I help people is to make available to them medical tests. Because the vast majority of my practice is nutritional then virtually all the tests requested are nutritional tests. One of my skilled helpers can advise patients on which test is most appropriate to their condition, the patient then chooses the test and when the result comes through I write to that patient’s GP with the result of the test, the implications for treatment and an invitation to come back to me for more information if required. A copy of the letter goes to the patient. This service has been greatly welcomed by patients recently and has been the main reason why the number of staff in my practice has recently doubled! It takes very little time for me to read a patient’s written history, interpret the tests in the light of that history and dictate a letter to their GP. Again, I have had a great deal of happy feedback from patients.
In the present day NHS, even patients now fully realise that services are limited by financial constraints. Increasingly they understand that they have to take responsibility for their own illness – they know they may not get their heart surgery if they are still smoking and they may not get their hip surgery if they are overweight. I have to say I am greatly in favour of people taking responsibility for their own health, and the service I offer encourages this further. There is no doubt that those people who are prepared to make lifestyle changes with respect to work, sleep and exercise, dietary changes with respect to eating healthily and taking a range of micronutrient supplements and those people who avoid toxic stresses such as excessive alcohol, smoking and junk food can not only feel health improvements immediately, but protect themselves from the ravages of chronic disease and degeneration. Making these changes is extremely difficult; that there is an excellent scientific basis for doing so, provides motivation and determination to continue.
“…..particularly the economics which would be of great interest to readers”. Little of this I am afraid, but a great deal of clinical satisfaction, happy patients, happy staff and most importantly happy me.