Consultants

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I don't want to be boringly repetitive but, in case someone new is reading this I'll just give,briefly, my PMR history.

I am 28 months in to my second bout, the first having cleared completely after three years. That was in 1999 - 2002.

No-one ever queried the diagnosis; I was a classic case.

For some reason a different doctor in the Practice said it would be a good idea to \" get into the system\" and referred me to the local rheumatology dept. I now regret agreeing to this.

I arrived in very good time for my appointment and was weighed, measured and had BP taken. Over an hour later nothing had happened and only one patient had been seen. Another patient had the same time as I had for his apppointment and a third was scheduled half an hour earlier. Finally yet another patient appeared and went straight into the Consultant's office. Apparently she ahd been held up in X-Ray

On enquiring I was told that there was a mistake about my appointment time. It should have been half an hour later. This I was able to demonstrate was not so as I had my print out with me having used the \"Choose and Book\" internet system. I pointed this out and was surlily informed that \"There are sometimes delays.\"

At this point I said I was not prepared to sit in the overheated, unventillated, windowless waiting area any longer. There were now two people ahead of me and the going rate seemed to be about one patient every 40 minutes. I came home having decided this was not a system that I wanted to get into.

Naturally, I let my GP know and said that I did not think thet the RH. Dept had anything to offer me that I was not already receiving from my local, ( beautifully run ) surgery.

On telling my sister who worked in the NHS for thirty years this story she said that she had actually heard said that Consultants' time was more valuable than Patients' and that if they did not want to wait they should go privately. So now we know!

Not only do I resent the attitude but would have no faith in anything offered by such a service

0 likes, 7 replies

7 Replies

  • Posted

    Hi BettyE!

    My experience with the consultant wasn't quite as bad in some ways in that I didn't get abandoned by the receptionists - he just didn't want to listen to me the second time at follow-up!

    However - the basic problem is the \"choose and book\" system that the previous government insisted on having introduced whereby the patient is supposed to have \"choice\". I think if you google \"monday books, sicknotes\" you should be able to find a link to an extract of a book that has just been published by a blogging GP where he has written a brilliant chapter about what that concept really means! I haven't laughed out loud at a book so much since starting my first Bill Bryson book. If that doesn't work I'll find the link I used to get it to read!

    In the old days the GP was able to write a letter directed to the most suitable consultant for the job and his secretary put you on his waiting list. Nowadays the GP is supposed to send the referral (on a form) and it is \"considered\" by a referral team. They decide whether the referral is \"appropriate\" on the basis of the information provided and may even decide you don't need to see a consultant but a nurse practitioner would be quite adequate. Or a physiotherapist, or whatever. It's not unknown for a patient to be told at the first (if they're lucky) appointment \"Oh, you need to see...\" which was actually what the GP had said in the first place. Back to square one. And if you have ever tried to use \"choose and book\" you will know that 1. the computer is down, 2. there are no appointments at any of the hospitals you chose or within 60 miles of your home, 3. you aren't in the system, 4. whatever..., in all cases please ring back later. After my fourth attempt I got a letter saying I had run out of time as I hadn't attempted to make an appointment! I sat with my GP for half an hour trying to capture an appointment on one occasion as it resolutely disappeared every time we tried to book it! We gave up.

    On my second appointment I saw a \"member of the team\". That would have been fine had it been a rheumatologist. He was a GP \"with a special interest\" in rheumatology. I'm not that picky, he'd have been acceptable at follow-up, checking drugs, that sort of thing. However, at that point we hadn't even come to a conclusion about the diagnosis. If I'm to see a GP then I'll have one with a special interest in ME - my regular, I've been seeing you for the last 10 years, GP. One of them will do fine (I'm even broad-minded enough to see more than one at the practice).

    I've been, married to or a mother of an NHS employee since I was 19 (and that wasn't yesterday :wink: ). I'm well aware of the problems but would still defend it with my dying breath - but it's been made such a mess of by non-medically experienced idiots that I despair (and a few with MBChB behind their names who should have known better) that it is almost not fit for purpose in some places. It's tremendous for emergency care and for life-threatening diseases - but if you have something obscure where the diagnosis isn't straightforward enough for the GP to deal with it and you live in the wrong place, you seem to have had it.

    Betty - I'd attempt a complaint about the receptionist if you have the energy. Generally there is a notice up saying if you haven't been seen within a specified period of time after your appointment time to mention it as it may have gone astray - or, either you should have been told facce-to-face or there should have been a very visible notice up advising you of the current delay in being seen for your consultant. And either way - the receptionist shouldn't have been rude. Given that most hospitals charge for parking it's hardly helpful to be kept 3 hours past your time if you paid for 3 hours (which should be too long anyway).

    Given that we DO have pretty much total choice, it would be ni

  • Posted

    Oh dear Betty, so sorry you had such a rotten experience. Mine couldn't be more different. I was in such a state back in September, my GP was scratching her head because all my bloods were coming back near normal and I was just two days away from a much longed for cruise. I phoned our local private hospital, asked for an appointment with a Rheumatology Consultant (I chose one who's name I liked!!) she phoned me an hour later, my Doctor faxed the referral. Six hours later I was started on 15mgs Prednisolone, another 12 hours and I could have run a marothon (OK - I could walk!) one day later I embarked on my cruise. She's wonderful. I saw her privately when I got back, £140 very well spent, and she then transferred me to the NHS even though I didn't ask her to. When I go to see her now at our local Hospital I take a copy of War and Peace as I know I will be waiting upwards of an hour or so because she's so popular and spends whatever time is required with her patients. I think I've just struck lucky because all the staff are lovely, always apologizing for the wait but I don't mind as I'm expecting it. I think in your situation I would have done exactly the same, my fuse is long, but not that long. My GP is great but she hadn't come across anyone with PMR (which she suspected I had) but no blood results to back it up and was reluctant to put me on steroids without advice. I don't really feel the need to see the Consultant very often now and we've agreed that I will phone her if I have a 'crisis' (?) if not I'm seeing her towards the end of the year. Do hope you are keeping well.

    Lizzie Ellen

  • Posted

    [quote:8aef12eccd]Betty - I'd attempt a complaint about the receptionist if you have the energy. Generally there is a notice up saying if you haven't been seen within a specified period of time after your appointment time to mention it as it may have gone astray - or, either you should have been told facce-to-face or there should have been a very visible notice up advising you of the current delay in being seen for your consultant. And either way - the receptionist shouldn't have been rude. Given that most hospitals charge for parking it's hardly helpful to be kept 3 hours past your time if you paid for 3 hours (which should be too long anyway).

    [/quote:8aef12eccd]

    [quote:8aef12eccd] £140 very well spent, and she then transferred me to the NHS even though I didn't ask her to. When I go to see her now at our local Hospital I take a copy of War and Peace as I know I will be waiting upwards of an hour or so because she's so popular and spends whatever time is required with her patients. I think I've just struck lucky because all the staff are lovely, always apologizing for the wait but I don't mind as I'm expecting it. I think in your situation I would have done exactly the same, my fuse is long, but not that long. My GP [/quote:8aef12eccd]

    Thanks Eileen and Lizzie Ellen

    I've ordered the book (£6.73 delivered via the magic Bookbrain site ) Looking forward to a good laugh. I think I'll skip the complaint and follow Lizzie Ellen's advice and pay for a proper consultation if it's ever necessary. As my usual GP got me through my previous bout of PMR ten years ago and I'm lucky enough to still have him I really do not see the need for anyoune else. Unfortunately I was persuaded on one of my very worst days by a different doctor. Usual man was stuck somewhere by the volcano! As you so rightly say, continuity is invaluable.

    I, too, would defend the NHS almost always. This same hospital gave wonderful care last year to a friend with a fractured radius with complications and ten years ago to my mother when she was dying. I couldn't believe the difference but, of course, it is always down to the individuals invloved.

    The notice in the waiting area said \"Please take a seat and we will call you shortly\" Please define \"shortly\". is what I wanted to say.

    When we visited the Fracture Clinic ( see above ) on four occasions last year we were seen within 15 minutes of the appointment time. This clinic had to pass patients from X-Ray to consultant to plaster room and we were still out within 2hours. On the one occasion when there was a delay it was explained that we would be seen 25 mins after our times... and we were. It can be done.

    I did have one small triumphover the system, though.We had three of our five hours left on our parking ticket which I passed on to some desperate man looking for a space. He said I was an angel. So there!!

  • Posted

    Hi Betty,

    Even better about the parking ticket is that it usually doesn't even go tot he hospital but to the company running the carpark! Which I TOTALLY disapprove of.

    Glad the rest of your experience is of the positive side of the NHS,

    EileenH

  • Posted

    Don't even get me on the car parking soap box!!! My Grandson has been steroid dependent since he was 2 years old (now 14) and is frequently at the hospital for check-ups and emergencies. How I hate the fact that someone, somewhere is profiting handsomely from this. Sometimes its as much as £8! I will step down from my soap box now.

    Lizzie Ellen

  • Posted

    Hi Betty E and others !

    I too saw a Rheumatologist ( privately ) like Lizzie Ellen when I first had PMR in 2002 and my blood results were too low My treatment was quick and effeicient but the Consultant had a very unpleasant manner and wouldnt want to see him again According to a friend who sees him via NHS said he is even worse then !!

    This time around I havent seen a Rheumatologist as a couple of other friends who see them say they wait for hours very rarely see the main man , are asked for blood tests they havent had , cancelled appointments etc etc

    When I had a really bad blip at the beginning of the year my Dr did offer to get me an apointment but she looks after me so well Im happy unless I have another blip My Dr never misses out on BP diabetes Dexa etc When I go in she already has looked at the bloods so knows where I am and always sends me off with a spare blood test form for emergencies and always has time and I feel I can ask her all my silly questions !!

    As far as I am concerned I feel that unless I could afford to go privately all the time the extra stress would be detremental and I get so much information support and ideas from here !!

    On my 7.5 now and blood tests and Dr next week so big decisions on how I reduce next After my blip in Jan I think about it more as with my first bout I went from 20mg to nil in 2 years and was fine and it never occurred to me this time around it wouldnt be the same So has been a blow At the moment I am feeling very good and able to do lots more ( Can now see all the dirt that has acccumilated in my house now and alll the weeds in the garden !!

    Best wishes to all Mrs G

  • Posted

    I agree Mrs G. If your GP is really on the ball then you can't go wrong. What I really like about my GP is - she listens, she does what I ask and when I ask and its working well - hence I'm not bothering to see the Consultant until late in the year. I needed a blood test for my cholesterol last week and asked her to put ESR and CRP on the form as well. Just got the results today - both on 2 :wow: My GP thought the Consultant was in a better position to advise me on steroid reduction so I went along with that. I'm on the 'take forever' plan - reducing 1mg gradually over a 7 week period - so its going to take 67 weeks to get off of them completely (if I can). The Consultant said it was the most effective way she'd found of getting around 2 out of 3 of her patients off of steroids altogether. Anyway, I'm almost down to 8mgs now and apart from needing a degree in Mathmatics to work out the dosage, its going well. I'll report back in about 50 weeks time :lol:

    Lizzie Ellen

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