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Hello, I am looking for your opinions on a couple of points please.

I am returning to practice after a short break (18 months on maternity) having sold my Clinic and moved to a different County.

I wish to return to work as self employed. The area that I have moved to already has 3 Chiropody clinics established. Having sold my practice, I decided that I didnt want to set up a new clinic in an area that already has 3 clinics,(They are all sole traders 2 male, 1 female), in a population of about 7000.

However, I think that there is scope for a domiciliary practice. Due to personal safety precautions (lone female) I feel i would prefer NOT to visit single male patients on my own. Instead offering visits to females,mixed couples and families. As I could refer the male patients onto the other chiropodists in the area, is this acceptable, or am I going to come under attack for discrimination?

Another point I am pondering, is writing a letter to the clinics already established in my area, introducing myself and announcing my intent to practice. I feel this is only polite, as they probably wont be best pleased about someone else opening up a new practice (albeit domiciliary only).

Any comments, thoughts would be helpful,
many thanks

Jo.

Related threads:
Starting home visits
Health & Safety during domicillary visits

Clinic setup questions
How to overcome 9 causes of practice failure
21 Ways to Keep Your Patients
Should I take the plunge?
Location, location, location!
New Clinic Advice
Purchasing my first podiatry practice
Advice needed re: taking the plunge and working for yourself

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Thanks admin for your links they're great. However I am still after opinions on those 2 specific questions.....

Helloooooooooooo! Anybody out there?? 55 views and no opinions?

Does Domicilary practice rate so low nowadays?

In the past I set up from scratch and ran a busy city centre clinic, but I have never done a doms only practice...so this is new to me.

Hi Jo,

To address you questions RE: setting up a new dom. practice, & also your decision not to treat lone males.

I think your intention to initially write an introductory letter to local existing pods to be a very good idea.

It lets them know not only the potential competition but also strengthens future professional ties. referral etc.

My practice is in a community previously dominated by the mining industry.

My patient volume (compared to many) would be considered very small. I have worked part time as a private practioner since 1998 & last year took the leap from p/t NHS & p/t P/P to full time on my own so it will take time to build a full time clinic.

I understand the average growth to build to full time is around 1 years trading to build each full day. (depends on area obviously).

A few weeks ago a colleague stopped by my clinic to introduce himself (hi Brian by the way) & I was pleasantly surprised to be contacted as working in isolation can be a daunting experience. It is a great idea to forge links with others as you may find that if these other clinicians have busy practices already they may not offer a dom. service themselves & may be grateful of someone to refer on to.

As to your decision not to treat lone male patients: personally I have no problems in this situation. I keep a list of all visits at home so my family know where I am & what time to expect me back (I also use the services of a company called Real Time Reception, who take my calls for me & they also keep a copy of my diary). However, if I have a gut feeling that a new patient is a little 'odd'' (they are out there but not always male!). I leave them to the last visit (always daylight though) & ensure reinforcements are available, ie. I arrange a family member to ring me while I am in the pts. house.

The areas I cover for doms are local to where I live so my 'troops' are never far away, but as I said, I have had no problems to date.

Always follow your instincts, if something doesn't feel right decline the visit or take someone in the car with you. Us girls generally 'get a feeling' when somethings amiss.

Good luck Jo, I hope all goes well.

Regards,



Mandy.

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twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

Jo,

Some very quick views.

7000 is a very small population to support 3 clinics.

If those clinics are anything like me, I clinic population 19000 with more within 10 miles, then they have to do both clinic and dom work.

I used to be on my own and life was good, now I have 5 doms competing against each other on price.

Am I happy?

No.

David H has written extensively on practices I usually defer to him on this stuff.

Bob.

Thanks Twirly & Bob for your thoughts, much appreciated.

Jo,
Hope you are well. Competition is healthy. A competitive advantage is even better. It's your business therefore you can choose who you wish to treat. In a limited population, if you select only one gender you are effectively discounting roughly half of that population. Be safe when entering anyones home. But even if the patient is female, how do you know there isn't a gang of men in the house too? Food for thought- you a tough cookie, take a ball point pen in hand and once your scalpel is "loaded" your in charge

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Hi Simon,

had a bit of an "incident" in the past that has made me a bit wobbly and perhaps over cautious now. All good points raised by you thanks, will sit back now and have a mull over with a glass of red (now the kids are quiet). Hmmmmmmm....

Jo

Kid's plural? You busy. I know some history as you know some mine, but you useful with big stick. ANd v. frightening when you on one. Give me a bell if you want a chat.

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Yep,
one five year old little girl and my 13 month old boy keep me very busy. Sold up my practice and came back down to settle in Cornwall, missed the moors....... So yes, thinking about going back to work, and rather like being self employed. Weighing up the options and possibilities...
So cheers, I may well do that

Hi Jo,

My thoughts are this. I hate going to peoples homes unless they are longstanding clients that are unable to attend my clinc. I have worked hard to set up a private practice that I am proud of, and I like to show it off.
So if someone approached me to let me know their intentions in providing that type of service, then I would be happy. Sole practitioners also like to meet others in their trade, and can happily refer back- not everyone, but most.

Good luck with the future.
Tree.

Tree, Thank you, Quite!

When I ran my city centre clinic, I was paying a lot for rent. I didnt want to pay high fees for a clinic and then not work in it. I explained to patients that mine was a clinic based practice. and that there were plenty of practitioners running home visiting practices, that didnt have my overheads to pay. I used to give them the phone numbers of those practitioners that did home visits.If they persisted i quoted a fee that incorporated standard clinic fee, plus fee for time spent out of the clinic, plus petrol.It was pretty exorbitant, but realistic ...as i would calculate the amount of appointments missed by doing the home visit.

I only ever did the odd home visit as a result. I was happy as I could concentrate on doing my work in my clinic.

I appreciate the completely different circumstances that a small population in my new county presents, and am currently mulling over my options

Jo

If it would make you feel safer why not carry a personal alarm with you in your case so that you can give them a bloody good frieght if things turn dodgy.

Jo,

Cornwall.

Now my heart is really sinking.

Where about?

Im the chair of the Cornwall branch, feel free to contact me by email.

We have a 'study' evening on Tuesday 19th Bedruthan Steps Hotel Newquay.

Why not come along.

Bob


Simon

Competition is healthy

I was going to start a new thread but cannot figure out how to do it.

Why healthy, I think monopolies produce the greater earnings.

As Suzy said in another thread Cornwall is well supplied from Plymouth Uni, I would have thought Plymouth was worse.

Cornwall does attract the 'lifestyle' movers, so we do seem to have a large number of pods for the population size, and another FHP about to finish training, not to mention the Stonebridge thing at Bude.

I agree a competative advatage is useful, did you manage to stay pure BMX or do you have to cut the odd corn.

Bob (again).

Bob,

"Jo, Cornwall. Now my heart is really sinking. Where about? "

Dont worry I'm nowhere near the coast! I am quite a ways inland.... To be fair I do have to earn a living somewhere, and finding part-time Pod employed work that fits in with family commitments etc is not always easy, when you dont live in a city.

We moved back to Cornwall because of my husbands work 2 years ago, am now planning to start back to work part-time, but as we already live here, I cant really work anywhere else!


I would like to take you up on your offer of the branch study evening, I will email you for details. Many thanks

Just an observation, i have noticed in my little area there are 9 hairdressers and 3or 4 beauty salons. How come the little population can support these? I guess there may be a larger transitory population from outlying villages? Are people more willing to spend money on hair etc than health for feet? Maybe I should offer Pedicures?? :-)

What do others think of this? (population , not pedicures!)......

Jo

The "health" of a podiatry practice is not just about turnover. Quality of service, value for money and patient choice.

My business has never been pure biomechanical, although it is a specialist area of practice.

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Simon:

As you can see, it looks like someone else might be into BMX riding as well.

Hi, I think you need to do a bit of research in the area before setting up doing DOM work. Don't presume that the other pratices will not welcome you into the area. Demand for private practitioners can be high and maybe these people are being over stretched. I would rec. you introduce yourself and state your intentions and play it by ear after that. It would be good if the other 3 practices were on good terms with you and rec. you to people they can't take on.
Speak to the HSE re lone worker rec's. I've never had any problem with people... only dogs!

Isn't that funny? My quaint town has a population similar to yours- will approx 7000 folks, and many weekenders. I was told by many other pods that the population size would be restrictive on the deveopment of any podiatry practice.
I honestly have found this to be fictional.

If my town can support 6 hairdressing salons, 6 GP's, 4 Physio's- then why not one sole podiatrist? I am finding that it is likely that a few podiatrists could cater to this population without concern. If you don't give something a try, you may be the one losing out.

Go the small towns!

Tree

from my first post...

" The area that I have moved to already has 3 Chiropody clinics established. Having sold my practice, I decided that I didnt want to set up a new clinic in an area that already has 3 clinics,(They are all sole traders 2 male, 1 female), in a population of about 7000. "

So you see its not just 1 pod

But hey if the Hairdressers and beauty peeps can get a market., then perhaps there is space for me too..........

Tree!, Sorry! have just realised I misread your post, you were talking about you as a lone Pod in your population werent you?

sorry! And thanks for the upbeat encouragement!

Simon,

With respect, the qualities you refer to are admirable.

However many businesses with just such quality aims fail because they do not make a profit.

In the context of Joe's posting IMO 3 clinics serving a population of 7000 would not spell healthy competition.

Still as others say if you do not try you cannot win.

Sorry about the BMX what on earth was I thinking about?

Bob

Hi,
just another thought really, although my immediate town area has a population of circa 7000,however outlying villages have another 7000, and the next town down from me has 1 pod serving an immediate population of 12000.

As I am going to be dom only I think perhaps it may make sense to offer these areas also. In fact I notice that many Pods doing dom work and having clinics in a city about 50 mins away from me, offer to come out to many areas that would take them up to 35 mins away from their clinics.

For me to get to the next town down is only 20 mins.

So thank you everybody for your posts, they have all been very helpful in helping me think things through. Many pertinent points were raised. Thank you.

Jo

Jo,

Good thinking, but.

You say it will only take you 20 mins, so what!

Your clients do not care how long it takes you.

Or are you saying because it only takes you 20 mins you can do it cheaper?

20 mins is an appointment time for me, OK truth is I like many work on 30 mins and 15 mins, but in a surgery you can always find something productive to do with the odd minute. (post on Pod A).

But on doms the travelling time is 'dead time'. Can you build in the cost of travelling into your fees and at what rate Pod rate approx £50 p/h or taxi rate?

The none house bound do this calculation, I think.

Sorry to be so 'fiscally calculating' but IMO this is an area the degree course does not address.

Bob

R.E.G.

You are totally correct, coming from a Clinic Based practice point of view, in that travelling time is an appointment time for you and "dead time". This is precisely the reason in the past, with my city centre practice, why I only ever occasionally carried out doms, and charged high rates accordingly.

However in my new situation, I do not have to pay for clinic overheads. Therefore, travel time is not in addition to clinic overheads.

The difference is, that for 20 mins travel time, I may have a fee paying patient, that I may not have had otherwise. With no clinic overheads, 20 mins "dead time" is an acceptable overhead for me.

The car running costs. petrol etc will have been worked into my Dom fee. These will be my overheads, not clinic rent, rates, water, elecricity etc....

My argument, when I was quoting my very high dom rate to patients, when I was clinic based,was that there were many dom only practitioners, who did not have my high clinic overheads to pay for, and therefore may appear to charge a more acceptable rate . I never wanted to do doms when i was clinic based, so therefore referred on those patients who disagreed with my rates to Dom only practitioners.

As i said in an earlier post, I disagree with doing Doms for peanuts, so will charge about the same rate for doms as the other local Pods are. Cant be fairer than that can I?

Jo.

Hi once again Jo,

I must admit to being relieved that you intend to charge accordingly for you services.

I am all for healthy competition (as I indicated earlier in a previous post).

What does irk me a little is the full time employed pods who locally are undercutting my service to pay for hobbies.

One local F/T NHS Pod. is advertising locally, charging less (paying tax? I can only guess...) But undermining those who are running a tax paying business.

Rant over.

Again Jo, good luck in you venture.

Regards,

__________________
:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

Jo

Try this link

http://www.stonebridge.uk.com/popup_foothealth.php

You may see some you know with a clinic near you.

ooo!

FHP's n all eh!...."never been in more demand".......

I think I may re-train, do a one or 2 day course and become a manicure/beauty therapist instead! I understand false nail infills are required every two weeks!

Never mind, Gotta make a living somehow

Wish me luck

Jo