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mrsurrey
22nd Apr 2012, 23:33
Hi All,

I need an operation (not serious but under general anaesthetic). There aren't any highly experienced surgeons for the operation in the UK so I did some googling for the operation and found that the world expert is Mr X in Denmark (he's done more than 1000 operations on my conditon). I emailed him asking him if there were any surgeons he would recommend in the UK, and he replied saying I should make an appointment with Mr Y in London.

So I printed off the email conversation and went to the GP for the first time in 15 years. He diagnosed the problem, then looked suspicously at my paper work and said "I suppose this is your internet research then?". He dismissed Mr Y as just Mr X's "mate" and said that he'd find a surgeon on his own and be in touch.

I then got a phone call advising me that I had been to referred to Mr Z. I then googled Mr Z and it appears he's done about a dozen operations on my condition, not reassuring.

I then did a search on the GMC website and find that Mr X (the world expert) is registered to do NHS surgery in the UK. More research suggests that Mr X is training Mr Y in London and making occasional visits. So I emailed Mr X (the world expert) and asked if he would be willing to operate on me in London within the NHS, to which he replies "no problem, just pay my travel and hotel expenses and I'll pop over and operate with Mr Y observing".

So now I'm heading back to the GP to get another referral, this time to Mr Y.

The problem is that I think my GP will take offense at the request and refuse.

So my question is if my GP refuses to refer me to Dr Y what should I do? I'm completely niave to the NHS so I'm feeling exposed
(I'm also concerned he'll tell me to see Mr Z (which may take 2 months) before considering a second referral, which could mean a total delay of 4 months just to get a referral)

Thanks!

MrS

fabs
23rd Apr 2012, 05:31
Your GP should refer you as long as it is clinically appropriate, it's your right in the NHS under 'choose and book'. You might have a wait though.

Gertrude the Wombat
23rd Apr 2012, 08:56
it's your right in the NHS under 'choose and book'
As my GP explained it to me, "choose and book" lets you choose which hospital you are treated at, it does not allow you to choose which consultant performs the treatement. Which to me seems completely and utterly pointless.

We did the same for a condition one of our kids had - looked up the world expert, emailed for a recommendation, got told to go to someone in London.

Which all worked fine, but we had to get BUPA to pay, the NHS wasn't interested.

Metro man
23rd Apr 2012, 10:36
If it's coming out of your own pocket, it may be worth looking at medical tourism to Asia.

Short waiting lists, low costs and a holiday on the side.

Bumrungrad International Hospital | Bangkok Thailand - Medical Procedures/Health Check-ups (http://www.bumrungrad.com/thailandhospital)

Worrals in the wilds
23rd Apr 2012, 12:22
Can Mr Y recommend a GP who will refer him, (off record recommendation if necessary)? A bit circular, but whatever works...

OFSO
23rd Apr 2012, 13:46
Barcelona has some of the world's top clinics/surgeons/hospitals, you might need to pop down on Ryanair twice (consultation, surgery) but I would have no hesitation at all in recommending Catalan medicos.

And as I said on another thread, everyone in the profession here speaks English (and French and German and Russian).

Private medicine means that successful clinics and hospitals (and doctors and surgeons) prosper; unsuccessful ones go out of business. The cream, as ever, floats to the top when there isn't a bureaucracy to get in the way.

Solid Rust Twotter
23rd Apr 2012, 14:39
Bumrungrad International Hospital...


Stay away from the curry perhaps?

Storminnorm
23rd Apr 2012, 16:00
I do my utmost to stay away from ANY of them.

My one remaining lung is working just FINE at the moment Doc.

Yes, my blood O2 level IS a bit low, why am I the only one that
isn't surprised by that?

Ancient Observer
23rd Apr 2012, 17:03
When our daughter had a potentially deadly illness, I checked with the quacks at work, who went on their secret websites and pronounced that Prof X was the world's guru.
Rang Prof's sec. No appointments for months, but see X, she's good and can help. If not, see Y....etc.

Told local GP all this. Local GP only interested in where the money trail went. Not interested in my daughter at all. Not interested in who might be able to help her.

Told them for go forth and multiply...... Asked them to reconsider. The GPs were not interested in the slightest. Only interested in the money trail.

fabs
23rd Apr 2012, 18:51
As my GP explained it to me, "choose and book" lets you choose which hospital you are treated at, it does not allow you to choose which consultant performs the treatement.

That all changed this month. As of Apr 12 you can choose the Hospital and the Consultant you wish to be in charge of your care. Of course it may be that you see one of his/her juniors but will be under the care of the Consultant.

At least that's what my wife says, she's a Consultant Surgeon.

Gertrude the Wombat
23rd Apr 2012, 18:59
That all changed this month. As of Apr 12 you can choose the Hospital and the Consultant you wish to be in charge of your care. Of course it may be that you see one of his/her juniors but will be under the care of the Consultant.

At least that's what my wife says, she's a Consultant Surgeon.
Interesting to know, thanks.

So now you can tell your GP "I want to see X", and the GP will tell you which clinics he does at which hospitals, and you can pick the hospital with the shortest waiting time?

fabs
23rd Apr 2012, 19:17
Yes mate, but 'don't let the GP give you any shit' (wife said that, must be a GP/Surgeon spat thing).
But it will be difficult obtaining accurate waiting time information until you get a letter with your date on it, not sure if you can keep chopping and changing once you've chosen.

Sir George Cayley
23rd Apr 2012, 19:43
Its different for the rich. Either through insurance or self pay.

Seems some Docs seem miffed when the ugly word 'private' comes up.

You have one life. The NHS has many Doctors.

Good luck

SGC

mrsurrey
23rd Apr 2012, 20:28
Thanks everyone, much obliged. Just to clarify this would be on the NHS organised through Mr Y's hospital in London, but Mr X would do the operation with Mr Y just watching. So it will cost me 1k-2k (for expenses and 'time' for Dr X), whereas going to see Mr X in Denmark would cost 14K.

Someone mentioned ringing Mr Y's PA and asking for a 'helpful' GP to refer me - how exactly would I go about approaching that GP and getting a referral (and how would I register with him/her?) Is it easy to ditch my current GP?

Many thanks,

MrS

Dan Gerous
23rd Apr 2012, 20:31
There must have been a point when Doctors X and Y had only done about a dozen of these ops. They had to get the experience from somewhere, as Doctor Z now has to.

McGoonagall
23rd Apr 2012, 20:37
Someone mentioned ringing Mr Y's PA and asking for a 'helpful' GP to refer me - how exactly would I go about approaching that GP and getting a referral (and how would I register with him/her?) Is it easy to ditch my current GP?

You wouldn't have to ditch your current GP. When you find out where the GP is book a couple of nights in a local hotel and register with him/her as a temporary resident for a consultation. He/she will then refer you to to MrY. Your GP will be kept informed with reports etc.

mrsurrey
23rd Apr 2012, 20:46
There must have been a point when Doctors X and Y had only done about a dozen of these ops. They had to get the experience from somewhere, as Doctor Z now has to.

There are no highly experienced surgeons in the UK for my condition because the operations are spread thinly across many departments whereas on the continent they have a few specialist deparments (for example Sweden sends all its patients to Germany for this treatment). It's appears to be just poor NHS planning.

mrsurrey
23rd Apr 2012, 20:50
Thanks McGoonagall

Gertrude the Wombat
23rd Apr 2012, 21:58
There must have been a point when Doctors X and Y had only done about a dozen of these ops. They had to get the experience from somewhere, as Doctor Z now has to.
My wife had an operation. Everything fine.

On one follow-up visit to the clinic she was for some reason walking past a notice board for staff and students, on which she saw an advertisement for a lecture her surgeon was giving on this amazing new operation that he'd just learned how to do, during which he'd tell the students how well the handful he'd done so far had gone ...

gingernut
24th Apr 2012, 23:36
You could appeal to the commisioners, (currently at the PCT), but I doubt you'd get very far.

What need's fixing?

Rossian
25th Apr 2012, 17:39
...in his day the mantra for surgeons used to be "watch one,do one,teach one".

Perhaps as an insider Gingernut can verify whether it still holds true??

The Ancient Mariner

mrsurrey
29th Apr 2012, 00:42
Thanks everyone for your support, I got the referral.

Basically the GP was relying on his research which was a couple of years out of date, and didn't believe the foreign surgeon would have a part-time NHS contract (a wrong assumption).

Incredibly then began a 20 minute lecture including such gems as:

1. "you need to get your head round the fact that you don't need a world expert" (but failing to explain why if one is available on the NHS I shouldn't use him)

2. to "stop trying to act as a consumer in the NHS - these people are professionals and you can't compare their services, the fact that they hold their positions is proof enough that they are at the top of their game"

3. "I think you're being silly, your condition is shared by a couple of other people in this town you know, you're not special"

4. "I've done all the research I'm going to do on this, if you want to do your own research that's fine but I'm finished with this"

5. "Other GP's have sent their patients to the surgeon I referred you to and they have been happy" - I pointed out this was a sample of 2-3 people versus the 1000+ patients that the world expert has treated.

6. Accused me for "falling for the hype of a publicity seeking consultant" - to which I pointed out that what is attracting me is the sheer number of operations carried out by the consultant. I asked how many relevent operations the surgeon he had recommended has done and he admitted that he didn't know but seemed to concede it would be less than 200.

6. "Please don't book another appointment as he stood up and ushered me out of the door!"

All in all a completely pointless and drawn out process, which cost me a month, blew many hundreds of pounds of NHS cash and nearly forced me to use a much less experienced consultant than was available. And all the time whilst my GP has been requiring 2 weeks notice for appointments, the world surgery expert on my condition has been freely replying to my emails within the hour!

On the plus side I have learnt that if you keep booking further appointments and repeating the same logical arguments he eventually gives up the patronising BS and gives the sodding referral! :ok:

MrS

Ozzy
29th Apr 2012, 00:50
stop trying to act as a consumer in the NHS

That really pisses me off - you ARE the consumer, you have already paid for it - IN ADVANCE!!

That GP should be bitch slapped up the head

Ozzy

vulcanised
29th Apr 2012, 13:03
bitch slapped up the head

Another medical term I've not encountered before.

603DX
29th Apr 2012, 13:20
Perhaps your GP would benefit from being on the receiving end of what my wife (a former SRN) used to say her Sister Tutor advocated: "High, hot, and a hell of a lot!" as a recipe for the perfect enema. And all on the NHS, of course ... That should alleviate his BS.

gingernut
29th Apr 2012, 19:37
Incredibly then began a 20 minute lecture

Lucky. He seems to have a lot of spare time.

OFSO
29th Apr 2012, 20:00
Mrs OFSO's aunt is suffering heart problems, water retention, swollen ankles but has just been diagnosed as having a "strained ankle ligament" as the cause of everything.

Hydromet
29th Apr 2012, 22:47
Mrs OFSO's aunt is suffering heart problems, water retention, swollen ankles but has just been diagnosed as having a "strained ankle ligament" as the cause of everything.
Is her GP an army doctor? You'll know for sure if he tells her to take two aspirin and bathe it every hour in hot and cold water.

JWP1938
1st May 2012, 16:51
100% true story: Lady fairly close to me had some persistent irritation problems "down below." Doctor (head of the practice) said "Well, you are 40 now, so it's time you stopped having sex anyway." Inconvenient to change doctor but she makes sure she sees one of the others at the practice now.

Milo Minderbinder
1st May 2012, 18:10
mrsurrey

change your GP

however theres an underlying question here which no-one so far has touched.
What is the risk factor for this op?
If high then stick to your guns
If low then what the heck are you arguing about?