Gearing up for a new year

As you go into 2018, I’m sure you’ve had at least some fleeting thoughts about a New Year’s resolution, or two. Perhaps a couple have already ‘slipped through to the keeper’! Changing habits can take real commitment and with a busy schedule it can be all too easy to slip back into your old routine or way of thinking.

Think before ‘signing your life away’

Often as a practitioner plans their next career move, they realise the restrictions imposed by an existing Employment Agreement. The importance of reading, understanding and negotiating acceptable terms of an Agreement before signing cannot be overstated. Once the Agreement is signed, it is very likely to be binding.

Tribunal reprimands practitioner for fraudulent self-prescribing

Self-prescribing and prescribing for friends and family is something that many practitioners grapple with. Having the medical knowledge and the ability make this easy, but there are many pitfalls and with unfortunate regularity it becomes a ‘slippery slope’. The Medical Board’s Code of Conduct has something to say about this practice.

Privacy and genetic information

The NHMRC Guidelines for Health Practitioners in the Private Sector for the Use and Disclosure of Genetic Information provides a range of scenarios designed to assist medical practitioners when issues of consent arise in relation to genetic information. Review this case.

New Code of Ethics for Midwives

The Nursing and Midwifery Board of Australia (NMBA), Australian College of Midwives (ACM), Australian College of Nursing (ACN) and Australian Nursing and Midwifery Federation (ANMF) have agreed to jointly adopt the International Council of Nurses ‘Code of ethics for nurses’ and the International Confederation of Midwives ‘Code of ethics for midwives’ as the guiding documents for ethical decision-making for nurses and midwives in Australia.

Rising to the challenge of a New Year

As the New Year commences it is inevitable that thoughts turn to plans for the year ahead. How will it be different from last year? What do you want to change and how will you change it? It’s the perfect time to review, reflect and make a plan.

MIGA Advocacy – Getting ready for changes to come

Significant changes around privacy, consent and surgical regulation will be introduced over the coming months.

MIGA has been advocating for the interests of its members and clients around these issues for some time, and we are seeing positive outcomes through our work.

Is complacency putting your practice at risk?

Unfortunately, the adequacy of the practice’s cover often only comes into focus when an incident has actually occurred and this is when the policy cover will be scrutinised. Unfortunately, it’s already too late if the practice isn’t covered or the cover is simply inadequate. This is both unfortunate and unnecessary given the nature of medical practice, where the ‘unexpected’ shouldn’t be too ‘unexpected’.

Support for Doctors in Training

Last year our Doctors in Training Grants Program celebrated its 10th anniversary, and once again generated immense interest from dedicated doctors across the country. We are pleased to announce the 2017 Grant recipients.

Australia Day Awards

Many of our members work tirelessly for the benefit of their local and broader communities and it is fantastic when their commitment and effort are publicly recognised. We congratulate our members who were recipients of Australia Day honours.

Red25 – Saving lives

MIGA recently joined the Australian Red Cross Blood Service ‘Red25’ Program and we need your help in achieving the Red Cross Blood Service’s goal of getting 25% of Australians to donate blood.

Federal Government Review of the medical indemnity framework

MIGA is actively involved in the medical indemnity framework review process, with the aim of representing our members’ interests and the broader profession fairly and constructively.

Patients refusing treatment

A General Practitioner recently contacted MIGA for guidance in relation to a patient who was refusing to follow advice. Unfortunately, this is not an uncommon scenario for members.

Midwives – New Code of Conduct

The Nursing and Midwifery Board of Australia (the NMBA) have released an advance copy of the “Code of Conduct for Midwives” (the Code), which is due to take effect from 1 March 2018.

When things get ‘hairy’

Issues that you may encounter in your professional life as a medical practitioner can be very complex, especially if they involve colleagues you directly work with or other medical practitioners you encounter.

Making the most of our Qantas partnership?

You may be missing opportunities to collect more points and access further discounts

Sharing your views – 2017 Member Survey

Understanding how you feel about the services we provide and our performance in delivering those services to you is extremely important to us.

How lobsters grow

Through MIGA Plus we have partnered with The Private Practice to offer access to Business Education courses designed for the healthcare profession and aimed at assisting doctors and practice managers.

What would happen if your business couldn’t operate?

As we head into the Christmas period, the prospect of storms and fire are obvious threats to any business. However, it’s often ... Read more

Reflecting on your practice risks – We can help!

We continually see that many of the issues that create legal and financial exposures for doctors and practices arise from a failure to plan and have adequate “risk management” measures in place.
The end of the year is a great time to reflect and make some changes to your practice.

MIGA Elective Grant recipients announced!

With 2017 applications recently closing, we were overwhelmed by the passion and enthusiasm of our medical student members, and are excited by the impact each will have on the community they visit.

Midwives snapshot – Back soon…

Ensuring that your clients are cared for while you are on a Christmas break takes a bit of planning, but here are some tips to make it as stress-free as possible.

Public interest suspensions

The Medical Board of Australia is expected to soon acquire new powers to take immediate action against doctors and other health practitioners where the Board “reasonably believes” the action is in the “public interest”.

When your patient won’t listen

In this digital age of on-line forums, blogs and Dr Google our clients frequently call us to discuss the management of patients whom have fixed views about the treatment they wish to receive. Patient autonomy is of course an essential and important legal foundation of the doctor/patient relationship. But to what end?

Firearms and reporting obligations

Dr Jones has been treating Peter who has a history of anxiety and depression. Peter recently had his firearms licence suspended and approaches Dr Jones for a medical report. Dr Jones had no idea that Peter held a firearms licence and is unsure about what he should disclose and whether he has any reporting obligations.

Understanding the risks in prescribing opioids

The National Drug and Alcohol Research Centre (NDARC) reported in July 2017 that the rate of accidental opioid deaths has more than doubled among Australians aged 35 to 44 between 2007 and 2013.

Midwives – Be careful with your advertising

Advertising who you are and what you do as a privately practising midwife is often a key part of letting women know about how you can help them through pregnancy, birth and afterwards. Like any business, you need to promote yourself. The key is doing so appropriately and sensibly.

MIGA Doctors in Training Grants Program

Considering an advanced training opportunity? Looking to enhance your skills and knowledge?
You could be eligible for one of four $5,000 Grants available to assist doctors undertaking specialist training opportunities in Australia and overseas.

Protecting your business – Avoid going up in flames

According to Fire and Rescue NSW, almost 40% of building fires are caused by electrical appliances and faults. A medical practice recently suffered this fate – their premises experienced $878,000 worth of damage after a fire tore through their offices.

Managing professional risks in your practice

At MIGA we have a wealth of experience in serving the needs of the healthcare sector. We understand medical practice and can provide you with professional advice, products and services to help you protect your practice and manage risk.

43,000,000 Qantas Points given to members

Our partnership with one of Australia’s most respected and recognised national brands provides a valuable way for us to recognise and reward our clients.

2017 Annual General Meeting

The 2017 Annual General Meeting will be held on Saturday, 25 November 2017 at the Hilton Hotel, Adelaide.

Changes ahead for Medical Indemnity

After more than a decade of relative stability there are some changes ahead for you and the medical indemnity insurance industry.

Emergency… Emergency… Emergency…

A decision to breach patient confidentiality should not be taken lightly and the balance between this duty and the duty to the community can be difficult to reconcile.

Who dunnit? – A poisonous pill

The increase in prescribing opioids in Australia is following a similar trend in the United States. The pendulum has swung from no opioids in the early 1980s to what is now being described as “prescription opioid abuse epidemic”.

Privacy risks in the online world

The recent extraordinary privacy breach by a Sydney cosmetic surgery has highlighted the importance of ensuring that patient information is protected and kept secure, particularly where information is stored online.

Midwives – Managing fatigue and burnout

In a profession such as midwifery where round the clock care is required, it is imperative that midwives increase their awareness about fatigue and burnout so that they are better equipped to improve the situation.

More benefits with Qantas Business Rewards

If you have an ABN Qantas Business Rewards membership, offers you many more benefits over and above Frequent Flyer membership. Find out more.

Am I covered when working as a doctor overseas?

For many doctors at some point in their career, an opportunity arises for them to work overseas either to train in their field, join a medical aid mission, or as part of their extra-curricular activities such as accompanying a group or sporting team.

Have your circumstances changed?

As your career evolves your practice circumstances can change frequently, particularly in the early stages of your career. Whether you are entering your initial fellowship training program, heading into private practice, moving interstate or retiring, these changes need to be notified to MIGA to ensure that you remain appropriately covered.

Understand your risks and reduce the chance of a claim or complaint

Understanding how risk can present in your practice is the first step in managing it! Utilise the activities in our Risk Management Program to learn about risk in your practice.

Beyond insurance – Serving and supporting you

When you insure with MIGA, you receive a lot more than insurance and you deal with an organisation that approaches its business and service provision from a different perspective than a commercial insurer. For clients who have experienced a claim, the claim management process is more than simply money changing hands. We are here for you, we consider your well-being and we offer support to you through the process.

Don’t miss your opportunity to earn Qantas Points this renewal

Through our Qantas partnership you can earn one Qantas Point for every eligible $1 paid to MIGA for your medical or professional indemnity insurance.

Practising within your area of expertise? A caution

A recent State Administrative Tribunal of Western Australia decision found that a medical practitioner behaved in a way that constituted professional misconduct by giving advice to a 10 year old cancer patient and her parents which lay outside of the practitioner’s experience and expertise.

“Goodness me could this be Medico-legal disease?”

‘Medico-legal disease’ is about when a doctor’s involvement in medico-legal matters, particularly claims or complaints involving them, have a significant impact on their own health. MIGA is conscious that ‘medico-legal disease’ can have devastating effects on a doctor’s confidence, relationships, physical and mental health, and potentially on their care of patients. These effects don’t necessarily end when a matter resolves. The disease can become chronic and, in some cases, doctors have walked away from medicine.

Supporting women in medicine: Room for improvement

At MIGA we are often contacted by our clients for advice in relation to various work-related stressors such as harassment, bullying, discrimination and ethical dilemmas. Anecdotally, we know these issues cause enormous stress for practitioners, however we are only now beginning to see research emerge from around the world that validates just how many doctors and midwives are affected by these issues in the workplace.

Could your business survive an interruption event?

When a client’s premises suffered serious fire damage, the business was up and running again within two weeks. Such a quick recovery was made possible because the practice had Business Insurance which included cover for Business Interruption. Their policy provided them with ready access to payments to cover temporary relocation and other after loss costs enabling them to resume normal trading.

The anatomy of a claim

In MIGA’s new Workshop “Anatomy of a claim” we follow the footsteps of Dale’s treating GP, and the specialists involved in his care pre and post-surgery, as they navigate through a coronial investigation, a complaints process and pending litigation. “I can’t believe it. Dale had gallstones, and he ends up dead. I thought I did everything I was supposed to do.”

Midwives managing risk – what’s on this year?

Check out the range of workshops available to help you manage risk in your practice, including our new workshop – “The perils of silence – Communicating for safety”

Simplify your renewal with direct debit

We’re always looking for ways to keep things simple for you, and maintaining your medical indemnity insurance is made easy with our convenient direct debit payment option. Payments can be made by monthly or annual direct debit with no additional costs or charges, even if you pay by the month.

Flying to new heights with our Qantas partnership

MIGA is proud to have entered into an arrangement with one of Australia’s most respected and recognised national brands. We know that many of you are frequent travellers for business and pleasure, so Qantas Points are a reward you can readily utilise. We believe it is a valuable way of recognising your loyalty and giving you something in return.

Privacy Act amendments what do they mean?

The recently passed Privacy Amendment (Notifiable Data breaches) Bill 2016 is expected to come into effect later this year. As private health service providers are regulated under the Privacy Act, the Amendment will require providers to notify the Privacy Commissioner of data breaches in certain circumstances and you should be aware of your obligations.

Managing complaints – Changes in Victoria

A new Health Complaints Act 2016 was introduced in Victoria and began operation on 1 February 2017. Complaints are now referred to the Health Complaints Commissioner who will work closely with AHPRA. The Commissioner has some new and important powers which Doctors in Victoria should make themselves aware of. The legislation sets out a Complaint Handling Standard which provides useful tips for health practitioners.

The perils of silence – Communicating for safety

Doctor Taupe is writing up a script for anticoagulation, observed by a trainee. The trainee pulls out his smartphone and confers with his medication app. He realises that the dosage being prescribed is too high.

Claims against practice companies are not limited to direct patient claims

Whilst claims are generally made directly against practices (entities/companies) by patients there is growing evidence of claims against practices being lodged by third parties.

NMBA – Nurse & Midwife Support Service now available

Nurses and midwives now have 24 hour access to confidential health support anywhere in Australia. The new service, which is a Nursing and Midwifery Board of Australia (NMBA) initiative, is run independently by Turning Point.

Am I covered when working as a doctor overseas?

For many doctors at some point in their career, an opportunity arises for them to work overseas either to train in their field, join a medical aid mission, or as part of their extra-curricular activities such as accompanying a group or sporting team.

Have your circumstances changed?

As your career evolves your practice circumstances can change frequently, particularly in the early stages of your career. Whether you are entering your initial fellowship training program, heading into private practice, moving interstate or retiring, these changes need to be notified to MIGA to ensure that you remain appropriately covered.

Understand your risks and reduce the chance of a claim or complaint

Understanding how risk can present in your practice is the first step in managing it! Utilise the activities in our Risk Management Program to learn about risk in your practice.

Federal Government announces increase in High Cost Claim Scheme threshold

The Federal Government has advised there will be an increase to the High Cost Claim Scheme (HCCS) threshold, with it moving from $300k to $500k per claim with effect 1 July 2018.

Congratulations – Australia Day Awards

We extend our congratulations to our members who were recipients of Australia Day Honours.

Dispelling the ‘doom and gloom’

A ‘mind boggling’ number of patient interactions occur each year, which puts into perspective the extremely low number of medico-legal issues arising.

Return to Work SA access to patient medical records

We are often contacted by our members in relation to section 183 of the Return to Work Act 2014 after they receive correspondence about this area and we thought it might be helpful to remind our members of their obligations.

Junior doctors – When things go wrong

Junior doctors are more vulnerable to some of the issues that come with practising medicine in a busy hospital; lack of experience, intense work schedules and frequent rotations and often a lack of support means that the risk of errors occurring is high.

New year – Changes for privately practising midwives

From 1 January 2017, new Nursing and Midwifery Board safety and quality guidelines for privately practising midwives come into force.

Make your own health a priority in 2017

The New Year is a great opportunity to set yourself goals; eat better, exercise more, read more books, but often these good intentions fade away as work takes over and the months start to fly by.

Need help achieving your business goals?

How will 2017 be different from last year? What do you want to change and how will you change it? It’s the perfect time to review, reflect and make a plan.

MIGA Doctors in Training Grants Program

Each year, MIGA offers doctors in training the opportunity to apply for a Grant to support their pursuits of advanced training. We are pleased to announce the 2016 Grant Recipients.

New year, new advocacy issues

MIGA is advocating on behalf of its members on a range of issues. Get the latest update and view our submissions.

Sharing your views on MIGA

We recently sought member feedback via a survey and were overwhelmed by your response, both in terms of the valuable feedback and the number of members who gave their time to complete the survey.

Caution! Buck passing

Recent observations of the NSW Civil & Administrative Tribunal provide helpful guidance on the requisite standard expected of a practitioner when referring to a specialist.

Email & SMS communication in medical practice

We have noticed a surge in queries from our clients about the use of SMS and email for patient communication, in particular recalls and reminders.

Surviving the ‘Silly Season’

The festive season is meant to be a time of joy, but for many people it can be a time of stress, anxiety, disappointment or loneliness.

Back soon…

The Christmas and New Year period can be a major risk to patient safety when health professionals head off on well-deserved annual leave.

Are your colleagues appropriately insured?

Policy cover between insurers varies and you may need to consider what happens when a colleague either isn’t covered or has inadequate cover.

Student Elective Grants – recipients announced!

Life is full of choices, and a medical student’s decision to help a community in need is a momentous one. Discover the six inspiring recipients of MIGA's Elective Grants Program doing just that.

Chaperones – Concerning and unsettling, or necessary and appropriate?

Why would you want to use a chaperone in some patient consultations? Doesn’t that mean there is a deficiency of trust in the doctor-patient relationship?

The joy of receiving this Christmas

‘Tis the season to be jolly and for gift giving. However, it is likely that you may also be offered gifts from your clients and their families at this time of year.

Had any interesting cases lately?

How often have you been asked at a dinner party as a conversation starter, “So, have you had any interesting cases lately?”?

Case study – Snake oil or ‘miracle’ cure

We understand the difficulties of being supportive in a heart-wrenching situation and, from a professional standpoint, also being an objective ‘voice of reason’. These situations are not uncommon and the choices they present practitioners can sometimes be clouded by emotion, a sense of obligation, or even guilt.

Working with you to transform the practice of medicine

Quality service delivery and satisfying careers for practitioners is a vision we share with MIGA. It is with great excitement that we present a series of courses and workshops in business, financial and lifestyle management across the country with special pricing for MIGA clients.

Sticks and Stones

Bullying and harassment have been a hot topic in the medical media with surgical specialties particularly feeling the heat.

Rocky relationships – Help at hand for midwives

Many midwives have called us to ‘trouble shoot’ scenarios arising from their daily interactions with their clients. Recently we had the opportunity to assist two midwives who found themselves in complicated situations.

Trending now – Multi-disciplinary practices

Is your practice part of the new wave of multi-disciplinary practices springing up around Australia?

New York City Marathon – Aussie assault

MIGA staff member Anthony Mennillo is mounting an Aussie assault on the New York City Marathon later this year – all in the name of a charity that has changed his life.

Lean on us

In a busy practice everyone needs someone to lean on. So when it comes to managing risk in your practice don’t forget that we are here to help. Here is a reminder of the ways we can help you and your team.

Dealing with the medical regulators

Medical Board revalidation and the Queensland Parliamentary inquiry into the operations of the Office of the Health Ombudsman are two key issues on which we have been engaging stakeholders.

Making a popular choice

The introduction this year of Direct Debit payments proved extremely popular with 26% of renewed policies now paying by this method. If you didn’t take the option to pay your premium by Direct Debit at the June renewal it’s not too late to set yourself up for an easy renewal next year!

2016 Annual General Meeting

We hope you will join us at the AGM to hear about developments in the last year at MIGA and to ask questions of the Chairman and CEO.

New MIGA Plus offer – Business Education

MIGA Plus - Now you can access Business Education courses at special rates.

Is your privacy policy up to scratch?

Recently, the Office of the Australian Information Commissioner (OAIC) released the findings of an assessment it made of the privacy policies of forty general practice clinics against Australian Privacy Principle 1 (APP1).

Language barriers – making sure your patient understands

The foundation of a healthy doctor/patient relationship is good communication. Language barriers can pose a significant threat.

Changes to your practice and Medical Board Registration

We have had situations where doctors have been working in a field of practice for which they had not been insured. While this presents an obvious risk, the less understood risk is the potential impact on the doctor’s registration.

Why do doctors avoid the doctor?

“Well, confidentiality is a big issue. It seems that if you are a doctor with an illness, it’s news for the medical grapevine.” Check out our new Doctors’ Health e-book and other resources to help you manage your own health.

Midwifery snapshot – Clinical notes to the rescue!

Our message of “document, document, document” can be a little repetitive so we are always pleased when we can share case studies that reinforce how clear, contemporaneous clinical records can determine the outcome of a trial as it did on this occasion, some seven years after the event!

Dr Thomas Volkman’s incredible experience –

“The expectations and trepidation stepping off the plane have been replaced with new skills, professional confidence and a sense of resilience.”

Advocacy snapshot

MIGA has a particular focus on advocacy in areas which directly impact on members and clients. Over recent months MIGA has made a number of submissions. Read more

“Secrets of the claim files…” –

We continue this very popular series of practice manager/owner breakfasts with a peek inside the claim files. You may be surprised what we find!

AGM & election of Directors

MIGA’s Annual General Meeting is scheduled for Saturday, 26 November 2016. It will be held in conjunction with a Risk Management Conference in Adelaide at the Hilton Hotel, Adelaide.

Queen’s Birthday honours

MIGA acknowledges and extends our congratulations to members who received Queen’s Birthday honours.

My Health Record & ePIP

The day to day use of this new system may bring with it heightened privacy concerns particularly in relation to potential breaches of privacy by doctors and/or practice staff.

The importance of your legal expenses cover

From 1 July 2016 MIGA has increased the cover for legal expenses for doctors to $1,500,000. This is very important protection for you – read why…..

Testing times – Let the doctor decide

A patient requests you to run a series of investigations at the request of a naturopath they have recently seen. Where does this leave you?

Prioritising your own health

A regular visit to your GP provides an objective assessment of your health and an opportunity to manage your health proactively. An undiagnosed impairment at its extreme has the potential to result in a catastrophic outcome for a patient and could be career ending, as it was in this case.

Renewing your insurance – Meet the Client Services team

The Client Services Team are available to assist you with your insurance questions, particularly at renewal. So meet the team and don’t hesitate to contact your Client Services Officer with your questions, they’d love to hear from you.

New Medical Board guidelines for Cosmetic procedures

New guidelines for cosmetic medical and surgical procedures will take effect on 1 October 2016. How will they affect your practice?

Advocacy – Representing your interests

There is constant change in medicine and MIGA takes an active approach to representing the interests of our members. Here is a taste of the issues we have been working on recently.

Midwifery snapshot – Refunding and waiving fees

It is important to deal with requests quickly, but good management is the key to resolving issues and finalising the matter. Consider these tips before seeking advice.

DiT Grants Program – Applications open

Now in its ninth year, the MIGA DIT Grants Program is again providing funding to assist doctors in training seeking to pursue specialist training opportunities in Australia and abroad.

Protecting you & your practice

With the addition of the new Business Insurance product, we can now protect the professional indemnity exposures for you and your practice and also protect the day to day insurance risks of your business.

Board news – New directors at MIGA and awards

We would like to welcome two new directors to the Board and congratulate two directors who recently received industry awards.

MIGA Plus – Access to a new range of benefits

MIGA Plus will offer new products and services sourced with your needs in mind, starting with Business Insurance.

Streamline your renewal – New easy payment options

From this renewal you can arrange payment by direct debit at no extra cost!

Ending the doctor/patient relationship

There are a number of reasons why a doctor may choose to end the doctor/patient relationship. We recommend a number of steps be followed if you decide to end the therapeutic relationship with a patient.

Independent contractor agreements – Are your arrangements in order?

Are you engaged as an employed doctor or independent contractor? In recent times we have seen an increase in disputes around the terms of independent contractor agreements, including disputes which have arisen in the absence of a formal agreement.

Midwifery snapshot – Testimonials in advertising

Websites and social media are a significant part of business advertising and it is important you satisfy yourself that your promotional activities are not in breach of the National Law.

Doctors – Estimating your Gross Income for renewal

With renewal approaching, we answer an often asked question – “What should be included in calculating my Gross Income estimate?”.

Meet the Claims & Legal Services team

We understand that the medico-legal process can be a world away from medical practise. Meet the team that advise and support our clients.

Understanding your risks

Our Risk Management Program is designed to assist you understand and manage risk in practice. With the new Program about to start, now is the ideal time for you to get involved.

Reader feedback

A clarification is required on our ‘Stop the clot’ article which appeared in the February issue of the Bulletin.

Practice Manager Breakfasts – eCommunications & IT reliance

Only two breakfasts remaining – don’t miss your chance to attend either in person or online!

Case Study – The violent patient

Violent attacks on health practitioners have become increasingly common whether in a hospital or the practitioners’ consulting rooms. The very people that are trying their best to help the public are under attack.

Case Study – Medicare

We have noted an increase in requests for assistance by practitioners to respond to audit enquiries or a formal investigation by Medicare. This indicates that Medicare have stepped up their investigation of medical practitioners in relation to Medicare billings.

Stop the clot

Communication is such an important part of daily life and in medicine poor communication can be the difference between life and death.

Midwifery snapshot – Care Plans

When a midwife notifies us of a matter that may involve a claim or complaint, we will ask for a copy of all the documentation relating to the care of the woman.

Doctors – New registration standards

From 1 January 2016 new registration standards apply to medical practitioners. These can be accessed via the Medical Board website.

Questions on notice

Am I permitted to release correspondence from a specialist which includes the disclaimer ‘Not for medico-legal purposes’?

Grant recipients announced

To support medical students and junior doctors, we run annual Grants Programs providing financial support to those seeking to expand their skill sets.

New role for MIGA in advocacy and industry submissions

MIGA keeps abreast of industry developments and plays a key role in advocating on behalf of our members and clients on issues that may impact them.

Affordable insurance premiums for hospital doctors

MIGA offers a range of insurance options tailored to the needs of hospital doctors.

Australia Day Honours

We would like to extend our congratulations to the following members on their receipt of Australia Day Honours.

Entering Private Practice for the first time?

Are you, or do you know a colleague, entering private practice for the first time?

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