SPEAKER_01 0:00

You're listening to Confidence to Thrive, a podcast for ambitious healthcare practitioners and entrepreneurs. Brought to you by Alex Biden. Welcome to Confidence to Thrive, the podcast helping growing practitioners and healthcare entrepreneurs navigate the challenges and risks of regulation while building brands that matter. Every episode we tackle a different issue facing healthcare practitioners or entrepreneurs. We interview a guest who's working on the leading edge of private healthcare, building something that matters in their sectoral profession. My name is Jody Rainsford, and on today's episode I'll be discussing with Christopher Cloak Brown and Roger Houston, directors at Our Litertity, the subject of the biggest mistakes healthcare practitioners make when dealing with a complaint or claim. Welcome, Christopher and Roger. Hello, hello, hello. Okay, let's get into this. In previous episodes, we've discussed what it means to receive a complaint or a claim and how it can derail a business if it's not dealt with correctly. But you guys are on the other end of the phone when practitioners reach out, when clients reach out, and so you must have seen and heard it all and have a really clear idea of the kind of common mistakes that people make that could be prevented or foreseen. Let's kick off. What are some of the most common mistakes that you see or hear practitioners making when they get in touch with you?

SPEAKER_00 1:20

Wow. I think Roger, you're the one I hear from you normally is it's normally somebody who's treated somebody last thing quite often on a Friday, who sort of persuaded them to give a treatment. And the call starts with, I knew I shouldn't have treated them. Yes.

SPEAKER_02 1:37

Yeah, if only I had a pound for someone that said, my my conscience or my my gut is telling me to avoid this patient. So there are two clear indicators from from the stuff uh that I see. I mean, just by way of context, what's our book now? We've got over a thousand practitioners. So if you lump complaints and claims together under the broad umbrella of they're an initial expression of dissatisfaction, so that can come from a verbal complaint, it can come from storming out the surgery and slamming the door, it can come refusing to pay the bill. It comes in a number of forms, but uh rest assured if you're a practitioner and you have someone expressing dissatisfaction, you won't confuse it for anything else. So that's the first point. You will be aware of it. Uh, it's the half past five appointment when the receptionist leaves at five and you're there on your own with these people. I'm not suggesting that there's a personal safety issue, but there is certainly a situation where you very quickly get down to their word against yours, notwithstanding the fact that you should have made contemporaneous notes. So that's the first point. The other clear indicator is people with an addictive history as a personality. It's very common for methadone users, so in other words, people being weaked off heroin to have their front teeth missing, particularly the top two front teeth for whatever reason.

SPEAKER_01 3:09

Right.

SPEAKER_02 3:10

Typically, that's not to suggest they've been knocked out by someone through trauma, they're just not there. So it's those those sorts of things where you really need the support of a clinic environment with someone. The other thing to say is the professional claimant. There are people that are around the healthcare sector that have no intention of paying for anything, and they end up habitually raising complaints. They are the serial complainant. Those cases generally tend to centre on dissatisfaction and they push very hard for a refund. But the the common themes that I see, and just to put it into context, we get three or four of these a week. So these cases are not unusual. Understandably, a practitioner that hasn't received a complaint before thinks it's the end of the world, they think it's all down to them, they think no one else has any more of these complaints. So I think one of the one of the things it's very important is to listen and understand and to actually say that you're not alone with this. In fact, it's an increasing trend from that point of view. But they revolve around in a formal claims context with that would really centre on consent and informed consent. So these things typically start off as dissatisfaction. So you know, bear in mind that we're in an aesthetic business in this context. It you know, it has the subject, the subjectivity about looks around it, and it boils down to a lack of brutal truth to say what are the reasonable expectations for this procedure. Uh, and they're quite happy to consent for it without really being brutally honest about prospects of success. So that doesn't necessarily mean it's negligent, but it certainly means it's suboptimal. And then you get into this whole frustration round of I haven't done anything wrong, but yes, you told me that it was going to look different, or I perceived you as looking different. And that comes down to the detail of the consent. The biggest area that I don't see in aesthetics that I'd like to see, that I do see elsewhere, is the risks are quantified. That's the difference between informed consent and just consent. You have to be really quite brutal as to the prospects of a satisfactory outcome. You need to quantify the risk factors as best you can.

SPEAKER_01 5:36

And then explain that a little bit more. How exactly do you mean it and how does that compare with other areas of healthcare?

SPEAKER_02 5:43

So Botox injections, particularly repeat Botox injections, where there's some suggestion that there's either a residual filler or there's dissatisfaction and they come back either from a previous treatment that you've done or a treatment that's been done elsewhere, and they're not happy. Now, the reality there is you don't have a magic wand, you can modify the amount of Botox that's injected, you can vary within a narrow margin the site of the injection. But broadly speaking, if you're going to try and improve one Botox outcome by injecting more, you have to be realistic about how successful that's going to be. You have to think of it from the perspective of the client because they're the ones that are going to be disappointed and raise the complaint.

SPEAKER_00 6:41

There's also this whole issue of informed consent. So uh it's very rare for Botox anti-wrinkle to to cause claims because it wears off after six months fundamentally. But we did have a fairly large claim from that, and the reason why that claim was successful was that the practitioner had completely disregarded the fact that the patient had an autoimmune disease. Right. So the autoimmune disease completely changes the risks of the treatment for that patient. So who consent and say, well, here's all the standard risks and so on? Well, they're not the risks for that patient because the anti-wrinkle, the Botox can trigger the autoimmune disease.

SPEAKER_02 7:23

Yeah, so the fault consent, Joseph, it has to be specific to that client or that patient. That client with the autoimmune disease are not most people.

SPEAKER_01 7:34

Yeah.

SPEAKER_02 7:34

So it has to be Pacific, and you have to ask a battery of questions and be sure you understand your patient. Such that you, I mean, some people will come to you and say, I've got this autoimmune condition, I'm not sure whether Botox is right for me. Can you tell me? That's fine. Others will deliberately conceal it. Now that's potentially a defense in terms of if they've been less than candid, but the courts take the view that you're the expert in the room and you have to really try and understand why this patient wants this procedure and whether they can undertake it given whatever constitutional factors are relevant. And that doesn't matter whether that obligation is on you, whether you're a doctor, dentist, qualified, non-medic, that obligation is still there.

SPEAKER_00 8:21

So I just think moving on, so that's the aesthetics, the well, the functional medicine is a whole different area. One of the biggest issues we see in functional medicine is because it's designed to be integrated with your own natural body chemicals, rhythms, and so on, is it's far less treatment-wise, it's far less aggressive than classic NHS treatments. Yes. And so quite often nothing obvious happens. The complaint is always, and it's all private and quite expensive because they're quite skilled practitioners. And so it's like well, I came to you, I've spent all this money and nothing's happened. Now that is awkward from just the commercial negligence perspective. It's even more awkward from the uh GMC regulatory perspective because the claim there is that you are giving treatment purely for your own financial gain, yeah, which is about as bad as it gets for the GMC.

SPEAKER_02 9:21

Yeah, so I think uh just on the functional medicine side, my sort of shopping list of issues go as follows. It's an area of complementary medicine where it seeks to sort of integrate with what's going on more generally. So there's the question of the diagnosis and who makes it and what's the standard of that diagnosis. My least favorite defensible diagnosis is what's called a diagnosis of exclusion, which is basically uh a bit like Sherlock Holmes saying to Dr. Watson, if you exclude everything, however, however illogical the cause that's left has to be the truth. You see what I mean? Yeah, so there's that to that, and that's not because diagnoses of exclusion are intellectually flawed, they are the least defensible because they are most likely to have another doctor have a different opinion, right? Right. So what gets a claim off the ground, if I'm a no-win, no-fee lawyer trying to make fees out of a case that is successful, is a supported breach of duty expert from another doctor. That's what gets a case off the ground, and that is more likely to occur if you are proceeding on the basis of a diagnosis of exclusion because there's more to pick at, because there is a legitimate range of opinion. And who's to say that the other side's expert giving an alternative opinion or different opinion to your functional medicine client is in quotes wrong. Bear in mind that the asymmetry of this is they can prove 1% negligence, they get 100% of the costs, as I've said to you before. So if you're in the business of wanting to pursue medical negligence claims for fees, which no-in-no-fee lawyers are, that's the golden ticket. So there's that. The other thing is a mismatch of expectations, as Chris says, so that the invoicing continues alongside the treatment plan. The treatment plan is not robust enough in what can reasonably be expected by way of an in-quotes improvement. And I don't know whether it's just a local phenomenon we'll see over time. We've had a rash or a batch of complaints, they haven't progressed to claims. Where the patient is a young adult struggling to get into university is a common thing. Anxious parents go to a functional medicine doctor to say, you know, my son or daughter is trying to get into Oxford and having yet another run of their A levels. So they're over 18, they're an adult, but they lack concentration, they lack this, they lack that. And then you find yourselves unwittingly breaching the child, sorry, the young adults at privacy in terms of how you interact with the parents who are dissatisfied with progress, but are still paying the bill.

unknown 12:18

Right.

SPEAKER_02 12:19

So there's a natural tension there. We've had a couple of cases where very well-meaning functional medicine practitioners have ended up breaching the patient's confidentiality. But of course, and then you've got this other constituent which is called the parent who's paying the bill. So that can get quite messy quite quickly. Fortunately, we haven't had one that's really progressed to a satellite case, which is about a breach of privacy. But were that to be the case, that would succeed.

SPEAKER_01 12:45

Right. Okay.

SPEAKER_02 12:47

So you need to be a bit careful on that. And the other thing in terms of commercial relationships and how you manage this question of well, I'm paying all this money and I don't see an improvement, is absolute candor in the treatment plan and evidencing that you're following the treatment plan. And at the complaint level, you are seeking to justify what you're doing to a lay person. So you come down to I've had two cases recently where the treatment plan has been complied with, but the documents that have been given to the parent as well as the patient have not had a consistent heading or label or description. So, what is a logical connection to the functional medicine doctor? You don't carry your laypatient with you on that because they don't understand, if you like, the lexicon of the language that's being used and the fact that this treatment plan is evidencing a particular result, which means you're on. But if you don't have the continuity of labelling, they can't follow the journey. So don't overestimate the medical knowledge of your patient. And functional medicine people fall into that trap because they think they're treating a cohort of relatively switched on patients who have found them out in the functional medicine sphere already.

SPEAKER_00 14:13

It's also to me, the whole functional medicine thing is probably particularly prone to that because as though it all sounds very natural and nature-based, and mind body attuned to you as a human and so on. The reality is, it's actually I go to these conferences and it is probably post-degree level biochemistry, is the level of the conversation there. It is not straightforward stuff.

SPEAKER_02 14:36

No, and your average functional medicine patient or parent of a functional medicine patient certainly isn't postgraduate biochemistry level. So it's interesting that that has come out as a factor. The other thing that is particular to functional medicine, although it's not unique, is just how time-consuming the dialogue is with these people. If they feel that they are not getting, and they're well researched, and they will compare what goes on with what they believe goes on elsewhere with a different functional medicine practitioner. So social media is definitely a factor in terms of discussion groups and how you will be compared behind your back by an audience that perhaps isn't qualified to judge you, but they still will.

SPEAKER_00 15:28

Not even behind your back, is the interesting thing is that it's all become quite fashionable now. And so it is this whole integrative, functional, and personalized medicine. So personalized being very important, it is personal to you and your particular circumstances. Uh and even I went to the the Nautic Labs conference at the end of last year. Um, when we think about improving your gut health about gut microbes and drinking yakholts in the morning, they've got supplements which not only have particular strains of gut microbes, well not have particular particular strains of gut microbes, but within that there's different variants of the DNA of the gut microbes, and then selected on the DNA of the gut microbes to achieve certain results. So it's actually got to that kind of level now, and so it's this enormous detail.

SPEAKER_01 16:19

Yeah. In that particular situation where you have a mismatch between the knowledge of the patient and the even though that they are very aware of other commercial options. Does that come about because there aren't processes in place from the side of the practitioner, or are they just completely unaware that they need to be thinking in terms of layman's terms? They need to be thinking of it because they've not had to do that before, they've not had a complaint before. What is the usual gap that causes that situation?

SPEAKER_02 16:54

Yeah, it's a bit of both, Jodie. Mainly, in my view, it's not trying to talk down to the patient, it's not trying to be condescending, which is where they think there's a danger if they try and oversimplify things. There's a natural level of respect for the patient, which is all well and good and appropriate. I think the most honest set of notes I've seen is this is they give the Janet and John version, and if they say to the patient, please don't be offended by this, but we need to make sure that we're all on the same page because there's some quite important sort of junction points coming up in the care plan. And we need to be sure that we're absolutely on the right page so that we end up going left at the points rather than straight ahead or whatever the analogy is. I think it's trying to not be condescending and that leads them into a trap where they believe the patient is nodding and agreeing and they're not understanding.

SPEAKER_00 17:49

That's the risk. I think sorry, Jay, just yeah, sorry, I think part of the problem as well is as I mean, functional medicine in places is achieving quite incredible results. And so the newspapers pick up on this in classic newspaper ways, and it'll be eat this diet and you'll live another 10 years. You'll see that headline all over the place now. Maybe it's because my feet attuned to what I do and so on. But I see every day I see two or three versions of that. And working in the sector, you know the underlying, and you know that's happened in this particular circumstance with this particular person with all this work and understanding and so on. But of course, you'll have the lay person will see that or go to the functional medicine doctor and say, I want that diet because I want to live for another 10 years. Now that might be appropriate or inappropriate, uh it all remains to be seen. So part of it is the sort of magic of emerging and done well, it does achieve incredible results, but it has to be done well for a person with layers and layers and layers of complexity.

SPEAKER_01 18:55

Yeah, absolutely. Going right back to the example you gave right at the start, where you talked about the majority of complaints are normally the last thing on a Friday at 5.30. It's a procedure done for someone and it's one word against another. Why do those happen? Do those situations happen because the processes aren't in place? And again, I think one of the common themes through the podcast episodes we talked about is about getting the processes in place and making sure that you have those things there, regardless of whether you've ever had a complaint before or not. Is it because the process is in place, or is it because there is a process in place but it's not being followed?

SPEAKER_02 19:34

Yeah, doctors are not very good at saying no, JD's.

SPEAKER_01 19:37

Right.

SPEAKER_02 19:37

That's what it boils down to. And the reality is that they will know in the cold light of day that they really shouldn't have fit put that patient in. Or the other the other one is friends and family.

SPEAKER_01 19:49

Right.

SPEAKER_02 19:50

You know, as we've said before, if you're gonna go to a summer barbecue, don't take a brochure with you, just don't do it. So it's this business sort of saying no.

SPEAKER_00 19:59

That's what we've heard recently, isn't there? There's an NHS course and how to say no politely.

SPEAKER_02 20:05

Yeah, yeah. So there are two things I I would say there. In private medicine, as we've been talking about this morning, this is all elective. You know, this isn't the NHS where by statute you can't close your doors without uh notifying a national emergency or regional emergency. The NHS acts do not apply. So it is entirely elective, and therefore you can select within reason, broadly within medical competence and what's best for the patient. That's the leading requirement as to whether you do a particular procedure or not. Uh, there's always a tension between that and the commercial reality of trying to succeed in a new business, so the pressures change over time. So, quite a lot of what we see by way of initial complaints are new practitioners who are clearly wanting income. So that needs to be balanced because you do error in haste and repentant leisure in this profession, like few others on the planet. I speak to people weekly that fall into that trap. The other thing to say is that you create the notes yourself. So the quality of the notes, the quality of the consultation is all within your gift, and there is a definite disconnect between the quality of what goes on within a consultation and what appears in notes that I eventually see as a defensive document.

SPEAKER_01 21:26

Right.

SPEAKER_02 21:27

That's just the way of it, and the close and the closer that gap, the more defense they are. And that comes back to what I told you is the gold standard before, where we can't stop notes being disclosed, but the notes have to be sufficiently comprehensive, robust, and accurate that they do not demonstrate negligence, never mind suboptimal treatment. And that's all within the gift of the practitioner. So every time, and it happens weekly, I speak to someone who thinks the roof is smaller than because they've had a complaint. A, in terms of context, they're certainly not unique. We have three or four of these a week, as I said earlier. But B, it's not all hopeless. Just because someone complains doesn't mean you need to reach for your checkbook to give them a hundred percent refund. You certainly don't encourage that because you won't last long commercially if you have a reputation for that. But equally, why would your notes be dismissed if they're accurate, honest, and robust and clinically relevant? And you write that the patient does. So it comes back to my ad old gripe that so many of these cases are lost by the defendant doctor, they're not won by the patient, and they're lost because the notes are poor.

SPEAKER_01 22:37

And what is the normal excuse for poor note-taking in these circumstances? If you have situations where someone has said, yo, I do take notes, but then you've looked at them and you said that they are they're poor. Is that because there is a lack of urgency, or is it the commercial pressure to spend less time note-taking because you're not earning money during that period?

SPEAKER_02 22:58

No, it it varies, Jodie. Some of it is is that they haven't been through the rigors of the NHS or are very good on documentation, despite what you may hear in your local pub in terms of notes and what have you. GPs are the same. So quite a lot of people are not inherently trained within the UK system. Uh doesn't mean they're not good physicians, but the note standards are taking elsewhere in the world is not the same as ours. Simple as that.

SPEAKER_01 23:25

Right, okay.

SPEAKER_02 23:26

So for the more successful practitioners, uh, they will cite commercial reality. You know, there's time pressures. The old adage, you know, I haven't got time to do this, but I always have to find time to do it twice.

unknown 23:39

Right.

SPEAKER_02 23:40

Those of us that work in busy businesses, there's plenty of that around. And again, with doctors, that doesn't commute translate to a defensible position. Yeah, some of them fall into the trap that they think their patient is their friend. I see far too many, particularly aesthetic notes from non-medics, which is like a chat with a girlfriend in the pub. These are medical notes. I think social media encourages a lack of formality, which is one thing, but that's not a replacement for clinical accuracy or you know, a comprehensive covering of what's gone on. Some notes packages encourage that. But I was saying to Chris only the end of last week, I was very impressed with one particular notes package because it forced, albeit from a fairly low non-psychiatric level, it prompted the practitioner to consider body dysmorphia and psychiatric components as part of the consent process. So it prompted the practitioner to think of that. Again, the number of times I've had people say, Well, I'm normally okay at picking up psychiatric red flags when actually the patient is got some real issues. I've had one case in the last week where the notes are very clear about you ruined my looks. I can't attend a judicial process that I'm obliged to. I have suicidal thoughts, I have this, I have that. And it tumbles out there's a potential for psychiatric medication pre-procedure. So why wasn't that picked up?

unknown 25:18

Right.

SPEAKER_02 25:19

Yeah, if I was a claimant lawyer, bingo, yeah, that's the chink in the armour. Yeah, so again, we're all very good at analysing these things after a claim has been made. So why can't we try and flush some of this stuff out beforehand and make our position defensible? So there's a variety of reasons.

SPEAKER_01 25:39

So say that you own a private healthcare business or you're a practitioner and you have a number of people working within the business. What would you suggest they do almost immediately or with greater urgency to make sure that they are encouraging and making sure that they are taking the right notes, they have the right process in place. What should they be looking at?

SPEAKER_02 26:00

So the best run practices do two things. They have peer reviews of medical notes as an ongoing oversight.

SPEAKER_01 26:06

Okay.

SPEAKER_02 26:07

You can couple that to clinical governance, which will tie in nicely to the requirements of the care quality commission if your business has that kind of oversight. And the other thing that's relevant is they have, I mean, it's called multidisciplinary team meetings within the NHS, but sensible private practice, whether it be surgery or anything else, have MDTs as well. So again, the better the better run practice. And I know you need a critical mass to justify an MDT. You don't for peer review of notes in my view. You can do that between two of you if you like, is to have on the cases that people are concerned about a different clinical view before you go off and make a mess of it. And the better run practices, whether it be aesthetics, private surgery, private GPs, functional medicine, they all have that. Peer group peer review of notes and MDTs typically weekly.

SPEAKER_01 27:09

And so these are practices that are common in NHS and common in terms of note-taking. So one of the issues is that people that haven't come from that background may not realize that that is that that is the standard by which you want to be aiming towards.

SPEAKER_02 27:27

Yeah. Yeah. So one of the things that Chris and I do, we you know, we'll we'll we'll say, well, what's your background and you know, what's your governance oversight? Now they're required to apply for CQC registration, some of that will be in quotes forced on them. But regardless of that, it's just good practice. And I mean, people get bent out of shape over this whole idea of governance. All it is a formalization of what's good medical practice, anyway. So if you're a beautician on the high street wants to get involved in some of this stuff and start injecting people or doing more permanent processes other than just surface beautician work or hair styling, that's the sort of discipline that you need to get into, and it will more than pay for itself in terms of defensibility and improving standards. So it doesn't have to be a huge overhead, but it is the best run practices with the best claims defensibility do that, and that isn't a coincidence.

SPEAKER_01 28:34

Right, okay. So there's a number of things I could do, and just wrapping this up here then, because I think we've covered the core points there. If anyone is concerned about whether they are doing this the right way, whether they have their practices in place, as we always say at the end of each episode, they are welcome to get in contact with you and you will answer any potential questions that they have.

SPEAKER_02 28:58

Yeah, so interestingly enough, Chris and I are off up north on Friday for our big day out in sunny Yorkshire. I hope it will be sunny, but it's not you get there. And part of what we're doing there is to look at practices and procedures, not to second guess the medicine, we never do that. That's not our job. Our job is to look at the defensibility of what goes on and what's recorded and what the general practices and procedures are, so that we can try and develop any different practices filling gaps so people are more defensive. And then we've got a question and answer session with the boys and girls up there in the afternoon, haven't we, to try and go through concerns? And one of the things that certainly I'll be saying on Friday, uh, and this particular practice already does this is if there's some concern, can you ring and we can discuss it if you've just seen the patient or in anticipation of a consultation? If the doctor's busy, get one of the nurses or the secretaries or the receptionists to ring, just convey what your concerns are, and we can have a conversation, filter things back. For this particular practice, I've done that three times now. And again, it's trying to prove a negative, isn't it? You know, in the sense that they all went fine and there was no adverse feedback. So was that a waste of time or not? I think you'll need to judge that. But potentially there were three quite serious complaints that we were able to head off before they got anywhere. So for the sake of a five-minute phone call, it's time invested quite well.

SPEAKER_00 30:26

And it's maybe for another time, but there's all sorts of things that people ring us about. So one of the things we've dealt with recently is as medicine becomes more and more embroiled with new technology. There's a functional medicine practice that was signing up for a service that was basically an AI, and it could detect stress in your voice. So basically you talk to something and it sends it off to the AI, and the AI tells you how stressed your voice is. So you then get into the whole GDPR aspects and data security and patient data and all these kinds of things. So we actually spent quite a bit of time going backwards and forwards on that, and even as mad as it gets, even into the geopolitics, because how long is Taiwan going to be Taiwan? That's quite an interesting process, but that's the sort of call we also take.

SPEAKER_02 31:33

Yeah, so this is one for the conversation in the snug this evening, is that the European Union, the EU have a view on data transfer and data management in Taiwan that's different to Singapore. So they'll approve what goes on in Singapore, not so Taiwan. We had to delve down into the depths of the services contract that this functional medicine practice in the UK was being asked to sign, in respect of a data development shop in Australia who had built this program, who were then having their data centre in Singapore, or was it Taiwan, over what the data they were going to capture per patient and how it was going to work by way of identifiability and all the rest of it. To say nothing of the commercials, which wasn't really my call, but certainly the contract and the GDPR requirements were front and centre and quite interesting discussing with this very forceful Australian as to why I shouldn't be worried if the data was kept in Taiwan.

SPEAKER_01 32:39

And in like in those situations with that, I does that it's come about because someone is aware of that, or is that something that you flag when it's mentioned as a bit of both.

SPEAKER_02 32:51

So this particular one, Jodie, the doctor was I'm a fan of slow horses. So dear old Gary Oldman, who plays the his her spidey sense to use that that phrase was set on to say, I've got a contract here, I don't quite understand. I'm a doctor, you know, I'm I'm not a contract lawyer. And and whilst we won't report to be that, we see quite a lot of these things. So she just said, Can you if I send this through, can you have a word and can you have a look and come back to me? So once I understood the context, because we weren't aware that they were pushing any clinical store by stress over a voice message, and then you get into the whole AI thing. So there's two ends to this. The back end is the contract with the software provider and what they do with the data outside the UK. Yeah, the next thing is how do you adequately consent and disclaim what AI will offer in a context of a consultation by a UK registered doctor, all right? So that's the next challenge. So that's the forward-facing patient bit, to say nothing of the contract in terms of what the data is going to do and how it's going to be managed and all the rest of it. That's an interesting example, but it's got two faces to it. The contract with the guy in Australia was the easy bit. Yeah. Bear in mind, if you work it through the patient journey, how the hell do you consent for that?

SPEAKER_01 34:14

Yeah, absolutely. Well, we're going to be talking about AI in a future episode because I think there's so many. There's so many implications around that that maybe people aren't even aware of. But for this episode, I think that's a great place to end it. I think we've covered very comprehensively as well. So all that remains to be is say thank you very much, Christopher and Roger, and we will see you on another episode. Thank you for listening to Confidence to Thrive. Before you go, please rate, review, and subscribe to Confidence to Thrive on your preferred podcast platform and help us spread our message to others who are making a difference in private healthcare. This podcast was brought to you by Our Litity. It's good advisors to support your business ambitions. Learn more about how our licity can support you by finding the link in the show notes or visiting our licity.co.uk.