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Private practice is unethical—and doctors should give it up

BMJ 2015; 350 doi: (Published 05 May 2015) Cite this as: BMJ 2015;350:h2299

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Re: Private practice is unethical—and doctors should give it up

I agree with most of John Dean's views on the current state of private practice and how it disadvantages both private and NHS patients. The idea that the patient gets a better service when seeing a consultant privately is bogus - the only advantage is speed of appointment otherwise the patient can take nothing for granted and must look out for their own best interests. I advise patients to always carry with them a set of their medical notes - you cannot rely on the consultant to have read of even seen them. Also always carry a spare note pad with you - not for the patient's use but the consultants. Don't rely on the practitioner having anything to record his or her observations on. Even though you may be charged as much as £200 for a 30 minute session in my experience the consultant may well have forgotten to attend to these basic matters. Of course there are occasions when even the most prepared patients can do nothing to help themselves and that is why the system needs changing. If you really need the consultants assistance to interpret a scan or some symptoms and all you can drag out of your expensive and time conscious professional is a few grudging words to the effect that "radiographers always say thing like that" or "You'll feel better tomorrow now I've told you it's not serious" then you are really no better off than if you were consulting someone you met in the bus queue. Likewise if you are unhappy with the opinion of an NHS consultant and tell your GP that because you want the matter dealt with quickly you will pay for a second opinion you are likely to find yourself referred to a private hospital where the consultant you see is a close colleague of the consultant who gave you the first opinion. We often hear that bullying is used to ensure conformity in the NHS but in these situations collegiate loyalty alone should be enough to put an end to diversity of opinion. Despite this I am not opposed to private practice in principal - just the ersatz kind which sees the NHS consultant treating his private patients as a convenient way of earning a few bob on the side. GJ George has a good point - if consultants believe in private practice why don't they set one up like he did? An increase in the number of genuinely private practices competing for patients might well do something to raise standards all around.

Competing interests: No competing interests

30 May 2015
Terry Bunn
19 Willow Road Liss Hants GU33 7EE