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Put a price sticker on your healthcare services...the need for price transparency in private healthcare

It’s not surprising that one area of private healthcare that the Competition Commission investigation is looking at is transparency (and competitiveness) of pricing in the private healthcare sector.

If you ask UK consumers, “What does it cost to see a private consultant?”, many will have little idea. The same applies for most private healthcare services. Ask someone what they think an MRI scan costs. Or what a hip replacement costs. You would get a wide variety of answers.

The industry is to blame

It’s the industry that is to blame for this. Healthcare providers from individual specialists to the major private hospital groups are reluctant to say, “this is what private treatment costs”.

We need to fix the problem.

Part of the problem lies with the way that private healthcare is funded. Around 80% of private treatment is funded through health insurance. In many cases the patient isn’t paying for the insurance; it’s paid for by the employer. The patient may get an idea of the cost of their insurance when it comes to looking at their annual tax return (where the health insurance cover is taxed as a benefit). But when it comes to “spending” their health insurance on private treatment, they are provided with little or no indication of what it is costing.

The story of Peter Patient

Let’s take an example of a typical insured patient experience.

Peter Patient has health insurance through his company. The scheme has a £500 limit on outpatient investigations and care, and a £100 excess. One day, Peter has a health problem and gets referred privately to a consultant at the local private hospital. He lets his health insurance company know and gets his referral “approved”. Peter goes to see the consultant. At no point is he informed what the cost of this consultation is. (Let’s assume it's £250). The consultant refers him for some scans and investigations. A scan is carried out that week in the private hospital. (Let’s assume this scan is £300). Some blood tests are requested. (Let’s assume £150). No indication is provided to the patient of what these scans and tests cost. Another investigation takes place privately in the imaging unit at the consultant’s NHS hospital. Again, no indication of cost is provided for this investigation. (Let’s assume £400).

So far, Peter Patient has racked up a bill of £1,100 before starting treatment. He knows that he has to pay £100 excess...but his outpatient care has far exceeded his £500 limit. He’ll probably find out about the “debt” he has built up when the bills get sent to the insurance company.

What about self-pay patients?

Surely it’s easier for self-pay patients to find out what private healthcare costs. After all, they are paying out of their own pockets. Well...it’s far from straightforward. On our Private Healthcare UK and GoPrivate web sites, our aim is to help patients make the right choice of private healthcare provider, be that an individual consultant, a clinic or a hospital. And one factor in making a choice is knowing what something costs.

But...what is the most difficult piece of information to get out of the consultants and clinics who are profiled on our sites? You guessed. It’s the price!

Let’s do it now!

The report of the Competition Commission investigation will not be published until 2014. My guess is that it will encourage (or make compulsory) the publication of prices for private healthcare services. Which means that consultants, clinics and hospitals will have to publish price lists.

But why wait until 2014? Be bold...you know what you charge for your services. It’s time to tell your patients!

Publicise your prices on GoPrivate.com

Enable patients to see what you charge, and make it easy for them to send an enquiry or book your services. Search for your listing or profile on GoPrivate.com and make sure that it is up-to-date, and your current consultation and treatment prices are displayed.

 89212 node 0 Shed some light
The future of private healthcare: Views and opinions from the AMII Conference

Last week’s AMII Conference brought together some of the leading UK heath insurers, intermediaries and brokers and provided some valuable insight into the challenges faced by the NHS and the UK’s private healthcare sector.

The conference was held against a backdrop of concerns over the stagnation of the sector and media speculation over the future of the UK’s free to access National Health Service.  10 years ago private medical insurance covered 11.9% of the population through corporate and individual schemes. But insured numbers have been in steady decline, resulting in the loss of over one million consumers of private healthcare services. Medical inflation has contributed to significant increases in health insurance premiums while at the same time the recession has hit both company coffers and people’s pockets. In contrast, the low cost health cash plan market is seeing growth, and the number of people who are self funding private healthcare is on the rise. The private hospitals whose business is driven by insured patients are feeling the knock on effect and are turning to the NHS to keep private hospital beds occupied at marginal cost.

Just over the horizon, the industry awaits the recommendations of the Competition Commission into private healthcare which may bring further pain to the sector. The need for innovation in healthcare delivery payment models and funding were recurrent themes throughout the event.

A model for 21st Century healthcare

Professor Nick Bosanquet from Imperial College opened the conference with his view of the 21st Century model of healthcare. He outlined his four stage model:

  • A focus on prevention rather than cure.
  • The need for early diagnosis and screening.
  • The development of active ambulatory services.
  • The adoption of care programmes with the provision of care closer to home, and improved communication with patients in understanding and delivering their healthcare needs.

He highlighted the 38% increase in NHS inpatient admissions over the years 2000 - 2010, and compared this to Sweden where these have only risen by 1%. At the same time, the NHS budget has doubled in real terms, and the number of consultants working in the NHS has risen by over 50%.

In Bosanquet’s view, the NHS is now in its 5th crisis period, perhaps worse than those in 1950, 1968, 1976, and 1987:

  • Public funds are reliant on tax income from younger tax payers, and these are becoming fewer putting increasing pressure on NHS funding.
  • The number of over 65’s will increase from 10.5 million to 14.2 million over the next 3 parliaments, fuelling the demand for NHS care.
  • We’ll see a 66% increase in hospital admissions of the over 75s.
  • Skilled staff shortages are becoming apparent within the healthcare sector.
  • A North-South divide is developing in provision.
  • And “soft option” politics mean that voluntary redundancy, agency cuts, and reduction in management numbers are often the route to greater efficiency.

A business with ageing customers will die (as do its customers!)

Like the NHS, the private health insurance sector is facing a crisis due to its “consumer profile”. Private health insurance subscribers are drawn from the older, middle and high income groups. But as they age, and require more (and more expensive) healthcare, the cost of health insurance premiums is escalating for individual and corporate scheme members. Professor Bosanquet had a very stark message for the health insurance businesses: “Insurers need to have 20% of their customers under 40. A business with ageing customers will die (as do its customers!)”.

The route to growth...Cost cutting or innovation?

Discussion was focused on fixing the problem. Panel members put forward their views on how the industry could meet the challenges. There was widespread conviction that there is a need for the PMI market to grow...but how could this be achieved? Through cost cutting to reduce premiums or innovation? Here are some of the views expressed:

  • Paul Moulton from AXA PPP believes that industry participants must work more closely together, providing a broader package, case management and involving  a combination of private and public sectors. The market can’t withstand medical inflation at 10%pa., resilience of market will come crashing down.

  • Nick Reynolds from Aviva is in favour of greater tailoring of services to different audiences, and putting more emphasis on prevention, screening, and the use of specialised providers. For him, the biggest challenge is the cost of distribution of PMI. Direct-only products may represent an opportunity. On the provider side, there’s a need for new entrants to stimulate some innovation.

  • Liam Kennedy from Pruhealth pointed out that nowadays patients have more freedom of choice under the NHS. Restrictive networks and cost containment are constraining consumer choice and making private health insurance less rather than more attractive.

The NHS in crisis...Is it the end of the free public healthcare system?

The demographic “time bomb”, and pressure on government funding mean that a “do nothing” approach is not an option. Now is “moving the deckchairs around on the NHS ship”.

  • According to Damian Marmion from BUPA, structural change is essential.  Lack of competition and lack of price transparency is expected to be covered by the Competition Commission review of private healthcare. But the recommendations may fall short of re-structuring the private hospital market in areas such as London. Quality and outcome measurement will become more important. Both the NHS and private sector will need to find ways of delivering better value to consumers.  Damian’s solution to the NHS would be threefold - separate the NHS from government control, create a health system that is the most productive in the world, and the most admired by its staff and the UK population.

  • Paul Shires from Westfield believes that referral management by the Clinical Commissioning Groups will become more prevalent in an attempt to restrict access. In the long term, the NHS has to focus on prevention and health education. In the medium term, a co-funding, co-payment is needed.

  • Andrew Halden from Reform pointed out that the NHS spotlight is often on A and E performance, waiting times and hospital performance. But the real problem is the pattern of care. In the past decade the NHS budget has doubled in real terms. Andrew and the rest of the panel saw little hope of tax incentives being introduced to encourage adoption of private healthcare. It would be seen as a subsidy for the better off. Although a voucher based approach might be a possibility where ultimate choice was given to the patient. The policies of all three of the main political parties policies are very similar. The integration of health and social care is a common theme. In Andrew’s opinion, cuts in other publically funded services have led to greater efficiency, more accountability and a more flexible workforce (e.g. the police). Whereas university education was heavily subsidised in the past, the public has come to accept (but not like) consumer funding or part funding of tuition fees. Perhaps, we are at “the beginning of the end of the welfare state.”

  • Fergus Craig from AXA PPP highlighted two key drivers for PMI: whether people (and companies) have money to spare in a recession and the relative cost of PMI. Even if the NHS fails to deliver and waiting times rise, people may still not see PMI as an affordable alternative.  At present, the industry provides cover for people with high incomes.  Providing healthcare through low cost company schemes could be the way forward.

  • Wayne Pontin, Chairman of AMII had the last say. Payment by results... Money is being spent inside hospitals when it could be better spent on diagnosis and prevention. Whether people are “buying” their healthcare through taxes which pay for the NHS or through private healthcare schemes, they need to understand the cost of healthcare. The NHS isn’t free.

So, some interesting perspectives on the future of the NHS and the private healthcare sector at a worthwhile and thought provoking event. We await the outcome of the Competition Commission enquiry with baited breath...

 89211 node 0 Health matters
The Team GB approach to winning healthcare gold

At the recent Independent Healthcare Forum in London, Ali Parsa, the CEO behind Circle, gave his view on where the UK is missing out in the worldwide economy and what we need to do to get back on track. His message was simple…focus on what you are really good at and give it 100%. His message rings true for the economy as a whole and for the private healthcare sector in particular. “Stop preserving the old, and create the new”.

In the recent Olympics, Team GB did better than ever before, not just because we were on home ground. When the country won the Olympic bid, the team behind the bid had to decide how we were going to deliver medals in London 2012. So they looked at those areas of sport where we are strong and invested their efforts and money in aiming to become the dominant force in that sporting sector. Sports such as rowing and cycling benefited. And they broke down success in that sport into every element that could contribute to winning a medal. The British Cycling performance director, Dave Brailsford, has described how they recruited athletes who had the right body make up for cycling, how they invested in every aspect of the bike’s performance, and how fitness and performance was examined in microscopic detail.

The end result? At Atlanta 1996, Team GB won one gold medal and came 36th in the medal table; in London 2012, Team GB won 29 gold medals and came third.

The UK has a similar challenge in the world economy. In recent years, the country has gone backwards in the international marketplace. We are not that far ahead of a failing Greece. So, we need to focus on what we are good at if we want to climb back up the medal table of the world economy.

We’re really good at healthcare!

And according to Circle’s Ali Parsa, one thing this country is very good at is healthcare. Despite the relentless media knocking of the NHS, we need to be a bit more positive about how good we are. If you watched the recent documentary on Great Ormond Street, you may have noticed how many of the leading specialists featured were not British. Why is this? It’s because, if you are a paediatrician anywhere in the world, Great Ormond Street is on your shortlist of “places I need to work to advance my career”. The Harris International Patient Centre at Great Ormond Street brings in over £25 million of revenue; children travel there from all over the world to be treated because they believe it to be the best.

It is encouraging to see a new initiative to export British healthcare abroad. A new agency will be established to link hospitals such as Great Ormond Street with foreign governments that want access to British-run health services Let’s hope this one gets off the ground and doesn’t suffer the fate of NHS Global which never got out of the starting blocks.

The “Olympic” message for private healthcare providers

If we tasked the British Cycling performance director with improving services in the private healthcare sector, how would he approach it? The “Olympic message” for the private healthcare sector is that if you want to be the very best at what you do, break down the delivery of a healthcare service into each constituent part and work to become a little bit better than your competition at every point in the process.

So, if you’re trying to attract self-pay patients for hip replacement:

  • Make your “first touch” whether it be via your web site, email, on the phone or in print that much better than your competition.
  • If you offer a fixed price package, don’t make it cheaper, make it more understandable, and add value to it.
  • If you offer a guarantee…make sure the patient realises that (many don’t!).
  • Make your admission process 10% slicker and 10% more customer friendly than your competitors’ process.
  • Make your post-discharge follow up and support 10% slicker and 10% more customer friendly than your competitors’. This will not be very difficult! If there’s one significant shortcoming in the delivery of the patient experience in the private healthcare sector. This is where it is. It’s time to get away from the “treat them, bill them, get them out of the door and forget about them” approach which seems to be all too common in our sector.

Let’s learn from our Olympic success, and deliver some golds for the UK healthcare sector to patients both here and abroad!

 89208 node 0 Team effort
WebWatch 2012 reveals health concerns of UK web users

...obesity and weight loss, not cancer or cosmetic surgery!

Once a year, we use Hitwise data to get some insight into how UK web users search the web when they are looking for health related information or visiting healthcare web sites.

The Private Healthcare UK report, "Healthcare WebWatch 2012" is the outcome of this research. It provides a snapshot of the health issues that UK web users are concerned about and the health and medical sites that the UK's web users are visiting.

It also provides insight into the private healthcare websites, health insurance company websites and cosmetic surgery sites that attract the most users.

So what are the biggest health concerns in the UK?

Obesity and weight loss are the greatest concerns.

Brits are more concerned with excess weight and how to lose it than any other health issue!

Our study found that 21 of the top 50 health-related searches concerned obesity, dieting, weight loss or getting fit. It demonstrates the increasing problem that the UK faces in dealing with obesity, and how more and more people are seeking advice and guidance over the internet; but it's encouraging to see that people are making positive moves towards self-help through the matching activity related to exploring and improving fitness levels.

Most frequently searched for disease

The specific phrases - "chicken pox", "shingles" and "diabetes symptoms" - were the most common disease/condition related terms typed into a search engine by people seeking health information.

Bear in mind that we're not saying that these diseases dominate health related searches...we're just saying that these specific disease-related phrases come out top.

Most frequently visited healthcare websites

Including commercial sites, the top five most visited healthcare websites are:

  1. NHS Choices
  2. Boots
  3. Weight Watchers
  4. Patient UK
  5. Netdoctor.co.uk

NHS Direct ranks 16th, below brands such as Holland & Barrett, BUPA and Specsavers.

Cosmetic surgery searches

After "liposuction", the most popular cosmetic procedure searches were for "breast implants", "laser hair removal" and "breast enlargement".

Surprisingly, the most common search terms for cosmetic surgery were not procedures but brand names "Transform", "Harley Medical Group" and "MYA", followed by "Cosmetic Surgery" and in fifth place "liposuction".

Who visits healthcare websites?

Health and medical websites attracted a significantly greater proportion of female visitors (52.9%) than websites in general (47.1%). 40.4% of visits to health and medical websites are made by people who are over 45.

Private healthcare company websites

The report examines traffic to company websites in the private healthcare sector:

  • Spire Healthcare is the market leader in the private hospital sector in terms of website visits
  • Aviva was the leading health insurance company website
  • The Harley Medical Group was the most visited cosmetic surgery company website

Download the full WebWatch report to learn more...

Some background to the report...

This is the fourth annual Healthcare Web Watch survey that we have published. The report is compiled using data from Experian Hitwise, based on a pre-defined Health and Medical market sector consisting of 1,769 UK based websites. The data used in the study was collected in the three months to 21st April 2012.

 89207 node 0 Health concerns
Cosmetic surgery...going up market in a recession?

In the last post, “Meeting the challenge of static demand and increasing competition in the private healthcare market”, I highlighted how organisations need to adapt their marketing approach in a recession. In particular, I made this comment about how patients and consumers buy services when money is tight:

“They will just be more selective and more rigorous in making the choice, especially when it’s on a self pay basis. You need to convince them that choosing your hospital/clinic/service is 100% the right decision, the safe decision, that you are the provider they can trust.

There’s some support for this in what has been happening in the cosmetic surgery sector in the UK. In a recession, you might expect people to buy less and to move downmarket to cheaper providers. So within the cosmetic surgery market, the companies that you might expect to benefit would be Transform, The Hospital Group and Harley Medical Group who offer lower cost surgery. And you would expect the major private hospital providers such as BMI Healthcare, Spire Healthcare and Nuffield Health to suffer as prospective buyers go for the cheaper option.

Growth or decline in cosmetic surgery?

So...what’s been happening over the last year or so?

  • May 2011: “Sales dipped by 2% at cosmetic surgery provider The Hospital Medical Group last year as difficult trading conditions continued to impact on the sector.”
  • August 2011: “Cosmetic surgery provider Transform is pinning its hopes on the market’s long-term growth opportunities after profits plummeted a staggering 86% to just £349,000 last year. Revenue slipped 4.5% on the previous year to £36.2m.”
  • November 2011: “Stephen Collier, CEO of General Healthcare Group reported that there had been sustained growth in demand for cosmetic surgery at BMI Healthcare.”
  • January 2012: “Audit figures from the British Association of Aesthetic Plastic Surgeons (BAAPS) reveal that the number of procedures continued to increase steadily by nearly 6%.”

Overall, it’s probably reasonable to assume that over the last year or so, less cosmetic surgery has been done in the UK...or at best, the number of operations has remained relatively static. But BMI Healthcare and BAAPS are saying that the number of cosmetic surgery procedures is on the up.

My reading of this is that some buyers of cosmetic surgery are becoming more selective and more rigorous in making the decision about where to go. Instead of going for the cheapest option, they move “up market” and pay more for what they perceive as a lower risk choice. Thus the top end of the market experiences sales growth at the expense of the lower end.

How will the PIP implants controversy affect the market?

The recent PIP implants controversy is going to make consumers think even harder about where they go.  It has raised concerns about regulation, operation and standards within the cosmetic surgery industry. In the UK, the Guardian newspaper has recently highlighted private cosmetic clinics that employ surgeons to carry out breast enlargements, nose jobs and tummy tucks who do not hold qualifications as plastic surgeons within the NHS (Private cosmetic clinics employing 'unqualified' surgeons). There are also concerns about the quality standards and practices of cosmetic surgery clinics both within the UK and across Europe. A new European Standard on Aesthetic Surgery Services represents a significant move to address these shortcomings.

Time for cosmetic surgery marketing to shape up?

There’s an interesting perspective on the cosmetic surgery market in this month’s Marketer (the magazine of The Chartered Institute of Marketing). In the article, Kate Hilpern asks: “Is cosmetic surgery marketing all about selling more procedures, or about helping customers to make informed purchase decisions?”



She has a very valid point! The recent evidence suggests that cosmetic surgery providers who focus on quality and service and helping the consumer make an informed decision rather than offering discounts and finance deals will be the ones who succeed in the long term.

 89206 node 0 Growth or decline?
Why do private patients travel abroad for treatment?

“Medical tourism” has become an established feature of healthcare provision for UK patients. According to the International Passenger Survey1, 63,000 UK residents travelled abroad in 2010 specifically to obtain medical treatment. By comparison, 52,000 overseas residents came into the UK for treatment. So, the UK has become a net exporter of patients. This is a remarkable turnaround from the heydays of the 80’s and 90’s when patients from all over Europe and the world came to the UK to benefit from the expertise of our clinicians and hospitals, particularly the expertise and services around Harley Street and our Central London hospitals.

A survey of the experiences of 650 medical tourists conducted by Treatment Abroad2 uncovered some of the reasons behind this patient exodus, and demonstrates that patient experiences of overseas treatment have been incredibly positive.

The motivation for going abroad varies for different types of treatment, but NHS waiting times and the high cost of private treatment in the UK are the primary factors. Savings on treatment costs were the main reason for travel for 92% of the survey respondents. Around 40% of medical tourists go abroad for dental treatment to countries such as Hungary, Poland and Croatia where savings of around 70% can be expected. Low costs of cosmetic surgery abroad have made cosmetic treatments available to middle or low income groups in the UK who previously could not have afforded treatment.

Although cost savings and NHS waiting lists are the key drivers for elective surgery patients (who are seeking operations such as knee and hip replacements), there are real concerns about hospital infection rates in the UK. 56% of the patients in the research said that choosing “safer” hospitals abroad is an important factor in their decision.

Despite the growth of “medical travel agencies”, around two-thirds of UK medical tourists arrange their treatment directly with a clinic, hospital, doctor or dentist. The medical tourism provider market is still very fragmented, and awaits the arrival of a significant player in the UK. There are many operators in the sector including one or two person “medical travel facilitation” businesses and individual doctors and dentists abroad who see the potential of the UK market.

The internet is now a key resource for people seeking information about healthcare, and this is certainly true of those considering treatment abroad. The internet is the main source of information for prospective medical tourists (68% rated it the main source of information), followed by magazines and newspapers (24%), and recommendations from friends or relatives (22%).

Expenditure per patient is significant: around £4,100 for dental patients, £3,400 for cosmetic surgery and £3,500 for elective surgery. In 2007, the UK medical tourism market is estimated at around £375 million.

But are these medical tourists happy with their experience? It’s a resounding “Yes!”

In the survey:

  • 97% of medical tourists say that they would definitely or probably go for treatment abroad again.
  • 96% of medical tourists say that they would definitely or probably go back to the same doctor/dentist/hospital/clinic.
  • 96% of medical tourists say that they would recommend treatment abroad to a friend or relative.

Until now, medical tourism has been largely confined to people who are prepared to fund their own treatment abroad. However, the proposed “EU Directive on the application of patients' rights in cross-border healthcare”3 will confirm the rights of NHS patients to extended patient choice...meaning that an NHS waiting list patient may opt for surgery within another EU state, funded by the NHS. (Patients already have this right under a European Court of Justice ruling4).

The EU proposals on the implementation of a European market in healthcare can only stimulate further growth in medical tourism. Medical travel is here to stay; the “early adopters” have been impressed by their experience and are recommending it to friends and relatives. It can only get bigger.

The challenge for the NHS and the independent healthcare sector in this new European market for healthcare is to establish the UK as a preferred destination for medical travellers. Fearful of a loss of NHS patients to other EU providers, many within the NHS  see the EU Directive as a threat and are concerned about the impact on NHS funding and facilities. On the contrary, it gives the UK an opportunity to re-establish itself as a centre of medical excellence and become the preferred destination for patients across Europe seeking the best in healthcare.

References

1 Office for National Statistics (ONS): International Passenger Survey.

2 Treatment Abroad Medical Tourist Survey 2008: See http://www.treatmentabroad.com/medical-tourism/medical-tourism-survey

3 EU Directive on the application of patients' rights in cross-border healthcare: http://ec.europa.eu/health/ph_overview/co_operation/healthcare/docs/COM_en.pdf

4 European Union: Judgment of the Court of Justice in Case C-372/04, 16 May 2006.

 89205 node 0 Treatment abroad
What do private consultants earn?

One of the “must read” sections of Independent Practitioner Today, a business magazine aimed at doctors with a private practice, is “Profits Focus”. Profits Focus is put together by Ray Stanbridge who runs an accountancy, and tax advisory service and Martin Murray, a partner at Sandisson Easson & Co, a medical accountants.

Each month they look at one of the private consultant specialties and work out what a typical consultant earns from private practice and what profit they are making, after they have covered the costs of consulting rooms, practice management costs and so on.

It’s a fascinating insight into the earnings of private consultants. Bear in mind that most private consultants are also NHS employees, so their private income could be viewed as what they earn from their part time job.

What does an NHS consultant earn?

But first...any idea what consultants get paid in the NHS? Here’s the basis for NHS consultant salaries for 2011/12. There are several elements to an NHS consultant salary:

  • Base salary: This depends on the number of years of experience. A new consultant is paid £74,504; A consultant with 9 years experience receives £89,370 pa; A consultant with 19 plus years experience receives £ 100,446 pa.
  • Clinical excellence awards: Basic salary is supplemented according to levels of clinical excellence. Clinical Excellence Awards are meant to reward consultants who perform over and above the standard expected of their role - consultants who can demonstrate that they’re delivering safe, high quality services:
    • A Level 1 Award warrants an additional £2,957pa;
    • A Level 5 Award warrants an additional £14,785pa;
    • A Level 9 Bronze Award warrants an additional £35,484;
    • A Level 12 Platinum Award warrants an additional £75,796 pa.

Around 30 consultants earn the top level Platinum award each year. Around 350 consultants earn the Bronze award each year.

According to the NHS Information Centre, NHS Staff Earnings report (January - March 2011), the average NHS consultant salary (under the new NHS contract) is £117,700 pa. (There are around 35,000 consultants working in the NHS.)

How do NHS consultant earnings compare with private consultant earnings?

So, a consultant earns £117,700 pa in the NHS. What does he or she earn from his private practice? Or...if you’re planning to direct your son or daughter towards a medical career, which specialty has the best chance of paying for a comfortable retirement for Mum and Dad...?

Here’s your answer, based on my analysis of the monthly specialty reviews published in Independent Practitioner Today:

Specialty

Fee income

Profit

Orthopaedic Surgeons

£168,000

£128,000

General Surgeons

£146,000

£94,000

Urologists

£114,000

£80,000

Opthalmologists

£121,000

£80,000

Cardiologists

£108,000

£79,000

Radiologists

£91,000

£67,000

ENT Surgeons

£119,000

£68,000

Gynaecologists

£105,000

£64,000

Physicians

£64,000

£47,000

Anaesthetists

£62,000

£47,000

Source: Independent Practitioner Today. Fee income and net profit for 2008, by specialty.

So, if your son or daughter is headed off for medical school this Autumn, make sure you send them off with a copy of the Oxford Textbook of Trauma and Orthopaedics (£237.50 from Amazon). You won’t regret the investment.

 89204 node 0 Surgeon's fees
How changes to Google can change your healthcare business

Private healthcare facilities and services, clinics, and practices doctors and businesses are attracting more and more patients and customers through the web. So, when Google makes a change that could significantly affect how your practice or business is displayed in Google search results, you need to understand the impact and what you need to do to as a result.

At Private Healthcare UK, we’re experts in understanding search engine optimisation for your kind of business. Google doesn’t stand still...it changes the way that it indexes web site content, it changes the way that it displays search results. We try to keep up with those changes so that our clients can benefit from our insight.

Google changes search results for location-based searches

Many patients and consumers conduct location based searches on Google. They type in a healthcare service and a location. One in five searches on Google is related to location (e.g. dentist London), which is why Google has been doing lots of work on making local search results better for searchers.

How it was before

The results page for a location based search previously featured a list of local results represented as pins on a map.

This appeared at the top of the page, above the normal search results:

The local search results were limited to a total of seven.

How it has changed

On the new Google results page, the pins and map are still present, but local results contain additional information such as contact details, a photo or a review and appear more like normal search results. The map has been moved to the right column and “floats” or scrolls down the page as users move down results.

For some searches, the majority of the page is taken up with local results. For example, try a Google search for “London physiotherapist”. People are likely to perform more and more local searches as they get used to the results, making it increasingly important for healthcare businesses to appear here.

How to ensure that your healthcare business or practice appears in the local search results

Google’s local search results are taken from Google’s Places directory - to get yourself listed, visit Google Places. You may already have a listing, and if this is the case, you’ll need to verify that you are who you say you are, in order to make any changes to it.

As well as your contact details, your Google Place page can also include:

  • Detailed information on your product and services
  • Photos
  • Opening hours
  • Live updates on special offers
  • Coupons customers can print out and use
  • Customer reviews

You can also get statistics on your Google Place page such as how many people have visited your page and what they searched for to get there.

 89203 node 0 New challenges

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