The NMJI

Successful Private Practice—Winning strategies for doctors. Aniruddha Malpani, Anjali Malpani. UBS Publications Distributors Private Ltd, New Delhi, 2004. 314 pp, price not mentioned. ISBN 81–7476–484–4.

Who does not wish to succeed in private practice? In that regard, this book should turn out to be a runaway success. The book attempts to lead the cadet doctor, by the hand, step-by-step, up the stairway of success. The stated aim is to help the doctor strike a critical balance between medical ethics, academics and professionalism on the one hand, and being an entrepreneur, financial wizard and chief executive officer on the other. All this while the punch line remains ‘Patients are practice. Everything else is just paperwork.’

The book is comprehensive. Beginning with where to start a new clinic, to designing it (this chapter lacks the touch of the lady author), there are brief discussions on every conceivable aspect of practice building. These include the doctor–patient relationship, use of technology in practice enhancement, how to make money and then make money grow, and medicolegal issues. The authors, being young themselves, also place a premium on balancing family life with professional life, a factor often forgotten.

Debates have been stirred in some chapters. For example, what is the place of ‘marketing’ of one’s practice in today’s world? The authors have taken a stand and justified the recent trend of aggressive marketing. They have redefined the ethical limits of marketing and advertising one’s practice. Many may not agree with their viewpoint. Similarly, the authors have been cautious to mention only the menace of the ‘commission’ system, but are not bold enough to either justify or roundly condemn it.

The book starts well. However, one-third of the way through it drifts into the realm of management—of money and human resource. This is the tedious bit. The checklists, as in many management books, make things look so simple, even when they are not. The section on ‘Communication and use of technology’ is interesting, though at several places a bit sermonizing. One often gets the feeling that the authors may have been inspired by an American treatise on the subject.

In the second half, the authors highlight some important issues. The advice of not to forget the family and children in the rat race to achieve success is well placed and needs to be underscored. Caution regarding the ‘burn-out syndrome’ and life after retirement are sensitive issues and the authors have done well to bring them out of the closet. Fads are not left out and even spirituality has crept into the discussion briefly.

I would have liked medical ethics to have been given more space and discussion, as this is currently a rage. But this chapter has been handled rather cursorily. The authors may have wished to steer clear of too many controversies, but then that is the single most important drawback of this book. The book throws up a whole host of questions, without really giving clear-cut solutions or alternatives.

The book closes with the authors’ view that ‘many doctors no longer work for the sake of working (whatever that means)—they are working for a car, a new house.’ If money was not important, what was the need to have a section on ‘How to earn more’ and ‘Boosting your bottom line’. Indeed, what was the need for this book?

Somewhere in the beginning, the book equates medical practice to a business that needs to make profit. The authors also opine that all the idealism and medical skills are of no use if you cannot make ends meet. They also describe an interesting concept of ‘wallet biopsy’ wherein you should learn to judge how much your patient can afford to pay. However, the authors leave us with an all-too-altruistic parting advice that we should not make the mistake of equating wealth with happiness. A bit confusing to me; does it make sense to you?
No doubt that there is a need for books such as these. But after reading this book one gets the feeling that one knew all this anyway. The nagging questions still remain—‘Will it work?’, ‘What will make it work?’ or more importantly ‘What will make it work for me?’ If you are fond of titles like ‘How to appear for an interview’ or ‘How to control your temper’ and if the tedium of having to read 300-odd pages is not daunting, the book is a good companion on a long train journey. Whether it is worth its price, I cannot say, as there is no printed price on the cover.