If I Were Starting Private Practice Again…

Starting a private practice in the UK can feel like stepping into a parallel healthcare universe, one where clinical acumen isn’t necessarily enough on its own, business structure, admin, marketing and financial planning suddenly become part of your daily vocabulary.

I asked a group of doctors and surgeons working in the private sector a simple question:

“If you were to start your private practice again, what three things would you do differently?”

The candour and knowledge they shared reveals a set of patterns that new private practitioners should take into consideration.

1. Get Your Business Structure Right From Day One

Nearly everyone agreed, the biggest early mistake is getting the company structure wrong.
Most wished they’d had better advice before forming their limited company or at least clearer guidance on whether they needed one at all.

Doctors highlighted things they learned too late:
• How their personal circumstances should shape the company structure
• Using a limited company to pay for life insurance, pensions, and SIPPs
• Understanding dividend rules and the real tax implications
• How (and when) to include a spouse in the business for tax-efficient income or pensions
• When it’s better to stay self-employed

One doctor got straight to the point:
“The accountant is critical to making money.”

Some went further, interview accountants yourself and choose one you genuinely click with.
The right structure wasn’t just about tax, it was about long-term planning, investment of profits, and avoiding pension tax traps later on.

2. Build Strong Infrastructure Before You Get Busy being Busy

Doctors often enter private practice thinking the hard part will be attracting referrals. In reality, the real work starts much earlier.

The most repeated piece of advice: Sort your infrastructure first.
This includes, but is not limited too:

A good secretary or PA

Loyalty came up multiple times. Several clinicians learned the hard way that the wrong secretary can make life very difficult.
• Tips included:
• Interview them personally
• Bring a seasoned admin or hospital manager with you
Don’t underestimate how much your reputation depends on them, they are often the first point of contact with the patient

Billing and financial management

Whether outsourced or done in-house, consistency is everything:
• Track every invoice
• Track every referral
• Use an electronic patient record (EPR) system that actually “talks” to hospital software

IT systems and software

Don’t overspend early, but do invest in:
• Reliable billing software
• A patient record system which is easy to use
• Clean, simple bookkeeping

One surgeon put it perfectly:
“Infrastructure is key to success. Only after you’ve done these three things should you start trying to grow your business.”

 3. Start Earlier, and be Smart

A surprising number said they simply wished they’d begun sooner.

Many felt they waited too long after becoming consultants; in hindsight, they felt this was wasted time.
Others emphasised where and how to start:
• Begin where your referring colleagues already work
• Pick hospitals close to home (you’ll thank yourself later)
• Don’t overlook Choose & Book several said it seeded their early growth
• Test locations and services, but double down quickly on what works
• Start slow and pressure-free if you can it often leads to more sustainable growth

And a reminder rooted in decades of experience:
“Availability, affability, ability – in that order.”

Word-of-mouth referrals still rule private practice.

4. Don’t Overinvest Early, But Be Strategic Where You Do

Many clinicians regretted spending too much too soon.

Early high expenses don’t equal early success.

The consensus:
• Keep costs lean initially
• Avoid shiny “nice-to-haves”
• But do invest in essentials that save time and money: IT systems, admin support, billing tools
Your first year is about stability, not scale.
 

5. Marketing Matters

Several senior doctors said the world has changed dramatically from when they started.
Reputation, hospital presence and academic prestige still fuel growth, but in today’s environment you need to incorporate:
• Social media presence
• Online visibility
• Professional but accessible branding
• Patient-centred digital communication

One doctor reflected:
“If I were starting again, I’d focus much more on social media.”

6. Be Available. Be Kind. Be Consistent.

Perhaps the the oldest and simplest piece of advice was:
Private practice grows slowly, through trust, reputation and time.

Clinicians emphasised:
• Be available
• Be pleasant
• Be technically excellent
• Build relationships with secretaries, GPs, colleagues, referrers, and hospital teams
Private practice is still, and probably always will be very much a relational business, never underestimate this.
 

The Bottom Line

Starting private practice in the UK is both exciting and un-nerving. But the collective insight from doctors who’ve already walked the path is clear:
• Get the structure and finances right.
• Build solid admin and IT foundations.
• Start a little bit earlier than you think you’re ready.
• Grow strategically, not expensively.
• Stay visible and stay human.

If you are considering starting out in the world of private practice, feel free to set up a call send an email or drop me a text so we can have a chat and discuss how we can help you with your private practice journey.