Setting up a GP practice

Anthony16

Could anybody give me a little detail on the costs involved and how strictly regulated this area is?I know pharmacies can only be set up if they are a certain distance from a medical practice,not sure if a gp has to jump through many hoops. My father is interested in buying(setting up) a practice for my brother when he qualifies.Also,are public patients freely allowed to change the gp who has their medical card?
Thanks

locum-motion

Anthony16 wrote: »

...I know pharmacies can only be set up if they are a certain distance from a medical practice...

What you "know", and what the actual facts are, are two different things!

L1011

There are no longer any rules on where you can place a pharmacy, as it happens. Deregulated maybe 10 years ago?

You can set up a GP practice anywhere, and you can now get a GMS contract with relative ease. This is a major change from before where you either had to get issued a "list" (contract with patients) or get a new entrant contract which could have had a rule preventing people from changing doctors to you for a set period.

Equipping a surgery is not cheap. The main Irish suppliers of equipment are quite dear, and there aren't many of them. Promed would be largest and they do have prices online: http://www.promed.ie/Medical.aspx . IT costs are large particularly at the start (albeit a fraction of the price of what you'd pay in the UK), makes sense to have a system from day one rather than work on paper and then have to try transfer that later. 30k might get all the basics in terms of furniture and basic medical supplies, 10k the computer system and associated wiring etc.

Space seems to be the biggest mistake people make when starting off, they either get somewhere that's designed for a huge practice and end up paying insane rents; or move in to somewhere that's too small within 6 months. You'd need to research the area you intended to open in, figure out demand and try make a good guess at somewhere that'll last for maybe 5 years before upsizing at a minimum. There's huge amounts of units with planning for medical use in retail centres across the country, a lot of them are absolutely massive though.

There is also the option of actually buying an existing practice - there are always some up for sale. There can be issues regarding the transfer of GMS lists in this case though.

locum-motion

I'd love to have been a fly on the wall in that house at breakfast to-day.

Dad: So, Elder Son, there's only another couple of years before you qualify, so it's time to think about where are you gonna set up your practice.

Elder son: Well, Dad, I'm not even sure if I want to be a GP. I thought I might spend a couple of years with Medecins Sans...

Dad: Don't be ridiculous. I've already had a chat to the estate agent about premises, and I've made an appointment with a lawyer for Monday morning...

Younger son: Dad, now you're being ridiculous. Everybody knows that when you want to set up in business you don't seek the opinion of experts. No, Dad, leave it all to me. I'll get all the information Elder Son needs by asking some randomers on the 'net!

El_Dangeroso

locum-motion wrote: »

I'd love to have been a fly on the wall in that house at breakfast to-day.

Dad: So, Elder Son, there's only another couple of years before you qualify, so it's time to think about where are you gonna set up your practice.

Elder son: Well, Dad, I'm not even sure if I want to be a GP. I thought I might spend a couple of years with Medecins Sans...

Dad: Don't be ridiculous. I've already had a chat to the estate agent about premises, and I've made an appointment with a lawyer for Monday morning...

Younger son: Dad, now you're being ridiculous. Everybody knows that when you want to set up in business you don't seek the opinion of experts. No, Dad, leave it all to me. I'll get all the information Elder Son needs by asking some randomers on the 'net!

That's a little harsh don't you think? Not everyone can inherit their practice from Daddy. Asking on the internet is a good a place to start as any. Just as long as the advice is not considered the final word.

OP get in touch with the Irish Conference of GPs also, they might be able to advise you more.

locum-motion

El_Dangeroso wrote: »

That's a little harsh don't you think?...

Actually, no, I don't think it's in the slightest little bit harsh. Not even one little bit.

Vorsprung

locum-motion wrote: »

Actually, no, I don't think it's in the slightest little bit harsh. Not even one little bit.

Mod Note

I disagree.

Helpful posts only please.

drzhivago

MYOB wrote: »

There are no longer any rules on where you can place a pharmacy, as it happens. Deregulated maybe 10 years ago?

You can set up a GP practice anywhere,

eh No
Planning permission a big issue here, many places turned down now because of access for those in wheelchairs

MYOB wrote: »

and you can now get a GMS contract with relative ease.

Eh no, that applies for people who have trained to be a GP, ie in Ireland or in UK we dont have a system where someone who has not done vocational training can just put their plate on a wall and immediately get a medical card list which guarantees some semblance of cash flow (note I do not state income)

MYOB wrote: »

This is a major change from before where you either had to get issued a "list" (contract with patients) or get a new entrant contract which could have had a rule preventing people from changing doctors to you for a set period.

A change yes but still can't just finish intern year and put plate on wall like people could 50 years ago

No rule about people changing to you if you had a medical card list, the issue was if you did not you could not take medical card patients or if you did they had to pay you or you treated for free as you would have no method of reimbursement

MYOB wrote: »

Equipping a surgery is not cheap. The main Irish suppliers of equipment are quite dear, and there aren't many of them.

AGREED

MYOB wrote: »

IT costs are large particularly at the start (albeit a fraction of the price of what you'd pay in the UK), makes sense to have a system from day one rather than work on paper and then have to try transfer that later. 30k might get all the basics in terms of furniture and basic medical supplies, 10k the computer system and associated wiring etc.

Not only does this make sense but you will be expected to make electronic returns on medical card patients and this it is a MUST

MYOB wrote: »

There is also the option of actually buying an existing practice - there are always some up for sale. There can be issues regarding the transfer of GMS lists in this case though.

Would not recommend buying a practice in current climate until govt decides how they plan to fund healthcare into future. List does not come with practice that would be advertised under public procurement unless one joins a practice as assistant for period of time before the principal retires and then it may transfer though robfowl can correct me on that

L1011

drzhivago wrote: »

eh No
Planning permission a big issue here, many places turned down now because of access for those in wheelchairs

That's an building requirement rather than a locational one. Obviously you could be unable to find or fund a building in the exact area you want, but that isn't the state preventing you from opening in that area; like they used to with pharmacies. But yes, its definitely something that has to be considered. Going for the top floor of a pharmacy with a steep staircase like a huge % of the surgeries in suburban Dublin is no longer a sensible cheap option.

drzhivago wrote: »

Eh no, that applies for people who have trained to be a GP, ie in Ireland or in UK we dont have a system where someone who has not done vocational training can just put their plate on a wall and immediately get a medical card list which guarantees some semblance of cash flow (note I do not state income)

I was assuming that the OP's brother was training to be a GP and in Ireland.

drzhivago wrote: »

No rule about people changing to you if you had a medical card list, the issue was if you did not you could not take medical card patients or if you did they had to pay you or you treated for free as you would have no method of reimbursement

There was - New Entrant Scheme I believe it was called. You could only take on people who had received first time cards or were moving area, not local transfers. Now gone, and I'm having trouble finding any reference to it online, but seeing as most information on the GMS still has the five year old reimbursement rates on it, that's not surprising.

This wasn't the same as a new post being offered, and it wasn't available to a large number of doctors either. Actually only know of one GP who ever took it, with an existing small private practice.

drzhivago wrote: »

Would not recommend buying a practice in current climate until govt decides how they plan to fund healthcare into future. List does not come with practice that would be advertised under public procurement unless one joins a practice as assistant for period of time before the principal retires and then it may transfer though robfowl can correct me on that

There is - or was prior to the recent changes, I can't confirm due to the paucity of information - a guaranteed transfer of list if you'd been an assistant to the principal for 7 years.

nino1

locum-motion wrote: »

. I'll get all the information Elder Son needs by asking some randomers on the 'net!

jeez, get out the wrong side of the bed this morning?

Who said he was going to get ALL his information on the internet?

He has gotten good advise so far and nowhere does he say that he is going to take the advise here as gospel, or act on it.

Vorsprung

nino1 wrote: »

jeez, get out the wrong side of the bed this morning?

Who said he was going to get ALL his information on the internet?

He has gotten good advise so far and nowhere does he say that he is going to take the advise here as gospel, or act on it.

Thanks nino, it's been dealt with.

Back on topic please.

Anthony16

Thanks a lot for the helpful replies. 40k plus the cost of the building and any additional renovation does not seem too bad at all. Of course I will get them to look into this further.
Cheers

gctest50

Ask an accountant or similar about leasing computers versus buying them - might be advantages there
You could spend quite a bit on something only to have it outdated in a short few years.

I'm sure there is way better options out there :

http://compub.com/finance/flexirent/

http://www.hardsoft.ie/networks-and-servers/