More tips for the specialist moving into private practice


Try to avoid forming cliques even though it might mean a higher chance of getting patient referrals. — AFP

In my previous article, I had shared eight items that I feel is important for a young specialist to know before joining a private hospital.

For those who have not read my previous articles in this series on surviving private practice in Malaysia, I left government service to join a new private hospital in Melaka as a specialist at the age of 34.

My fellow pioneer doctors and I worked very hard to build up this new hospital, and we celebrated our 25th anniversary in 2019.

I am now a senior consultant obstetrician and gynaecologist.

Like most private hospitals in Malaysia, all us specialists work as solo practitioners, with little interaction with our colleagues most of the time.

However, as part of the pioneering team in a new hospital, as well as due to a change in ownership, I had to learn how to interact with all the resident specialists, as well as the management of the hospital.

Over the years, I have gained much experience on how to build good relationships with the various stakeholders of this hospital.

Some of my experiences were good, while others were not so pleasant.

And although these experiences are often talked about casually among doctors, I do not think anyone has actually written about them.

That is why I decided to share what my experience has taught me.

Here are the remaining eight tips for young specialists.

9. Avoid forming cliques

It is common for specialists to form alliances with counterparts in other specialities.

For example, a gynaecologist will form a clique with a general surgeon, a urologist, a physician, an orthopaedic surgeon, an ophthalmologist, an ear, nose and throat (ENT) surgeon and so on.

By forming such a clique, they refer their cases to one another.

There are advantages and disadvantages of forming this kind of group.

The advantage is that you have a chance to get cases from doctors in your clique.

The disadvantage is that you are obliged to refer a case to one of the doctors in the group, even though you might think that another doctor is better qualified to handle your patient.

My advice is that it is better not to form such alliances.

Leave it to the politicians to create alliances; as doctors, we must be ethical in providing the best care for our patients.

10. Don’t feel bad about colleagues not referring cases to you

You are the new kid on the block.

Doctors in all the specialities have their own habits for referring patients, and it is difficult to break this habit.

Some will indeed refer their patients to you and you must be grateful to them for helping you.

However, it is not their obligation to refer their cases to you.

You have to be patient and engage with all the other doctors in the hospital.

You have to prove to them that you are a good, well-trained doctor, so that they will send their cases to you.

When you are the new kid on the block, you need to prove to your colleagues that you are good enough for them to refer their patients to you. — AMITA SEVELLARAJAWhen you are the new kid on the block, you need to prove to your colleagues that you are good enough for them to refer their patients to you. — AMITA SEVELLARAJA

11. Don’t be upset if a good friend consults another doctor

This has happened to me on numerous occasions.

When this occurs, I usually feel dejected and ask myself why am I not good enough for them.

You and I must realise that deciding on who will be their doctor is the sole prerogative of the patient, even if he or she is your good friend.

There may be many reasons for their decision, and not necessarily that you are not good enough for them.

Just consider it to be their loss and move on.

There is no point in sulking over it.

12. Engage more with nurses and paramedical staff

They are part of your team.

In a private hospital, you rarely work with another doctor, especially one of your own speciality, but you work with nurses and paramedics all the time – they assist you in all your work.

Have a good relationship with them and treat them with respect.

13. Continue to teach

You learn the most when you teach.

Teaching can be in the form of lectures to your nurses and paramedics, to specialists in other disciplines in your hospital, or for a local or national body.

By teaching, you will be seen as an authority in a particular subject and that will propel your career.

Some people may think that teaching means giving away your skills to others, but on the contrary, teaching will make your students look up to you and they will always have something nice to say about you in the future.

Personally, I have continued imparting whatever I know to medical students, young doctors and specialists throughout my career, even while in private practice.

Get to know your nurses and paramedic staff as you will be working more closely with them than your fellow doctors. — FilepicGet to know your nurses and paramedic staff as you will be working more closely with them than your fellow doctors. — Filepic

14. Don’t believe everything management tells you

The management of a hospital will tell you all the good things about a hospital before you join them.

Every hospital has its good and bad points.

The most important thing is the working environment.

You need to talk to the doctors in the hospital to understand the “DNA” of the working environment in the hospital.

15. Don’t be dejected if another doctor in your speciality is brought in

This is not uncommon, and might feel particularly trying when your own practice isn’t sufficiently established yet.

The hospital management has its own key performance indicators (KPIs).

One of it is to bring in as many specialists as possible, as the more doctors there are in a hospital, the higher the chances of their success.

The hospital management doesn’t owe you anything; it is up to you to attract patients to your practice.

16. Engage with the management

The management of the hospital wants doctors to sit on different committees.

These are voluntary committees required by the Private Healthcare Facilities and Services Act.

These committees include the MDAC (Medical and Dental Advisory Committee), Ethical Committee, Operating Theatre committee, your speciality committee and so on.

Many senior doctors are too busy to participate in these committees.

As you are new and have more time, engage the management by offering your services.

By engaging with them, you will have more exposure to the workings of the hospital.

The management has a limited budget for advertisements and promotions.

If you are close to them, they may choose to promote you in their advertising campaign.

As more and more specialists are looking for opportunities in private practice, hospital owners have more opportunities to handpick the doctors they want to work with.

It is a very competitive environment out there and you have to plan your career carefully when you choose to work in a private hospital.

Dr S. Selva is a consultant obstetrician and gynaecologist, and fertility specialist, in private practice in Melaka. This is the sixth article in a weekly series about surviving private practice in Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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