1. Focusing on self-pay patients will help your insured patients

If you focus on the self-pay market then you will realise the importance of producing information and providing clear pathways to nurture patients who visit your website from their initial enquiry through to having their procedure and beyond.

If you produce this information then this will help you to develop a more informative website and processes around your website.

This information and advice will also be useful and relevant to insured patients and so will improve the experience that your insured patients receive.

2. Treat people the way you think they should be treated

When you are working in the self-pay market, you can deliver the service that you want to deliver.

You have a lot more control over the number of follow-up appointments you can give and the length of your appointments.

If you think that MRI is better than ultrasound, then you can go straight for this investigation.

If the gold standard is to use a certain type of implant, or a particular drug, then you can offer this.

You decide on the investigations and treatments that you perform and you do not need to take in to account budgets or rationing.

This will give you the freedom to deliver the best service that you can.

There are far more opportunities when you are in the self-pay market because your focus is on thinking about what is best for your patients and how you can deliver value.

If you are able to think about the ideal pathway for your patients, this will help you to craft a better service for your insured patients, which you may be able to deliver within the limits of the insurance company or you could offer as an added extra (see point 3).

3. Insured patients can be self-pay

Insured patients are the same as self-pay patients, they just happen to have insurance.

You may deliver a perfectly good and effective service to your insured patients but there may be areas where you could do more.

For instance, insurance companies will often only pay for one follow up appointment.

This might be appropriate and most patients may not need more than one follow up appointment, but there may be situations where patients would like to be followed up.

Cardiology and neurology are two obvious examples where patients can be very worried about their symptoms, even though from a medical point of view there may be no cause for concern.

It might be helpful to explain to patients that you offer a service in your private practice where you can follow them up for a consultation fee. It can feel awkward doing this for an insured patient as we seem to have an inherent feeling that the two shouldn’t cross.

We are often blinkered by the concept of discharging patients who do not need to be followed up which is standard practice in the NHS, that we don’t realise that some patients may want to be followed up.

It is about getting away from the notion that if you are a cardiologist, your job is to diagnose ischaemic heart disease when in fact your job is to allay fears and worries about dying of a heart attack.

It is perfectly reasonable to offer follow-up appointments to patients who are concerned and this can be done in a completely ethical way by being transparent and open about the fact that there may be no medical grounds for concern yet you offer a service where you can keep an eye on them in your clinic.

In some situations discharging patients is not helpful because if they continue to have symptoms, they won’t know where to go to and will often go back to the GP and may feel lost.

4. Control over your patients 

When you start to develop the mindset of encouraging self pay patients, then you start to take control over the flow of patients into your practice.

You need to think about reasons that patients should choose you rather than one of your colleagues and this will strengthen your position and give you a much more sustainable private practice.

If you are relying on insurance companies or the hospital for your flow of patients then this can significantly affect your practice.

Furthermore, insurance companies will often require you to be fee assured and this allows them to set their fees and gives you very little leeway if they choose to change their fee structure.

When dealing with self pay patients who are coming to see you, then you can control which hospitals you treat them in and how much you charge.

You will have a much more sustainable practice that will stand the test of time and give you much more autonomy.

This is the first step to developing your own personal brand and making your private practice a business rather than just a job.

5. You Realise How Much A Patient Is ‘Worth’

When you treat patients who are self pay, you feel like you owe them to deliver a good service.

However, when dealing with NHS patients or insured patients, it somehow seems that they are not paying for it, and so you don’t need to deliver such a good service.

Of course, patients are paying for their treatment one way or another, whether it is NHS, insured or self-pay.

..but having that direct link with their payment makes you realise how much each patient is worth.

This became apparent over the lockdown period.

I would encourage my colleagues to do ‘virtual consultations’ and when the insurance companies announced that they would be reimbursing for them, it became a lot more attractive.

However, in my own Private Practice, I had to think of ways that I could add value to my ‘virtual consultations’ because I felt that if patients were going to be paying for them, they might want something more.

However, for those that did insured work, they didn’t feel the need to add anything extra to the ‘virtual consultations’ because they were getting paid anyway.

If you realise the value of patients and accept that they are paying one way or another, then you might think how you can perhaps add a slideshow, or some online help or advice in the form of videos or other digital assets given that you won’t be able to see the patient in person and examine them.

Just because you are treating a patient who is insured, doesn’t mean that you shouldn’t be constantly thinking of ways that you can add value.

Ultimately, I think that your goal should be to move in to treating a higher proportion of self-pay patients, because this is where you can achieve much more control and scalability of your practice.

However, even if this is not achievable or desirable to you at the moment, you should still think of your patients as self-pay as this will tighten up your service and encourage you to think of ways to deliver more value

…and this can only be a good thing.

Please feel free to comment below, I read all the comments and welcome feedback.

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    4 replies to "Five reasons you need to focus on self pay patients no matter what speciality you are in"

    • anand mani

      I couldn’t download your “5 steps to building a valuable practice”

      • staianoconsulting

        Sorry about that, the website was down for a period of time yesterday, but it is back up and running now.

        There seemed to be a problem with the servers and they are looking in to it, but it seems to be working normally now.


    • Shaumik Adhya

      Thanks Jj. Helpful as always. We have to realise our value and actually deliver on our promise! This will differentiate us and make us more valuable to our patients.

      • staianoconsulting

        Yes, I think the key is to try to see things from the patient’s point of view and when you do that, you realise that there is value in things that you may not have realised (like a personal phone call to see how they are, or a handwritten card to say thank you for a review). JJ

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