How to select a consultant for unknown condition?

DullGreyGuy

I'm fortunate that I'm generally in good health and so rarely have need to see a GP let alone a consultant. The couple of times I have needed a referral either the GP has recommended a consultant by name or has had a good idea what's wrong and so could narrow down consultants based on their specialty.

So, been told need to see a specialist consultant but the GP didn't know any to recommend a particular individual and has no idea what the cause of the problem is (the previous GP's official diagnose was "that's really strange"). 

Looking at my insurance provider they have 275 consultants with the specialism in London on their books. Most operate in central London at times so how do I go from that to deciding on one? Each lists their areas of interest but with not tentative diagnosis I cannot match. I dont know anyone who's seen such a specialist in London for a personal recommendation. 

beckstar1975

Your GP should at least be able to confirm if you need to see Gastro/Ortho etc - if they can't even do that then they need to either to a bit more digging to start narrowing it down or tell you that there's really not much joy going further without a bit more detail first. If it was NHS what would be they doing? 

beckstar1975

Sorry - pressed send too soon, when I've needed referrals I've looked at who in our local NHS hospital I'd be referred to and then look to see if any of them work privately - and this has worked well for me so far. When I needed to find a ortho surgeon the physio I'd been seeing recommended one, which worked well for the post op rehab as they happily bounced me between each other

DullGreyGuy

beckstar1975 said:

Your GP should at least be able to confirm if you need to see Gastro/Ortho etc - if they can't even do that then they need to either to a bit more digging to start narrowing it down or tell you that there's really not much joy going further without a bit more detail first. If it was NHS what would be they doing? 
When I've needed referrals I've looked at who in our local NHS hospital I'd be referred to and then look to see if any of them work privately - and this has worked well for me so far. When I needed to find a ortho surgeon the physio I'd been seeing recommended one, which worked well for the post op rehab as they happily bounced me between each other

Yes, they've said the specialism but looking at the doctors in the specialism they all list a few items that they focus on but without any hint at a diagnosis I cannot match to them. The GP has said they dont think it's X Y or Z but those are the most common listed interests by the consultants (and what you'd think of when if someone named the specialism).

Our NHS and Private hospital are neighbours, there are 18 consultants in the NHS hospital and at least 10 of them do private practice next door and are covered by my insurers automatically... others may also be working there but dont have agreed rates. Then there are private consultants who work for different NHS hospitals but do private practice at our closest location. Then there are all the other private hospitals and their doctors which wouldnt be too hard to get to. 

One of the recommended by the insurer is a clinical director and head of the specialism at the NHS hospital according to his profile with the insurer but he's not listed as a practicing consultant on the NHS website and randomly coming across his LinkedIn profile its all talking about business management in Healthcare and Directorships etc so maybe too far removed from the clinical work these days?

Thanks @beckstar1975

Undervalued

DullGreyGuy said:

I'm fortunate that I'm generally in good health and so rarely have need to see a GP let alone a consultant. The couple of times I have needed a referral either the GP has recommended a consultant by name or has had a good idea what's wrong and so could narrow down consultants based on their specialty.

So, been told need to see a specialist consultant but the GP didn't know any to recommend a particular individual and has no idea what the cause of the problem is (the previous GP's official diagnose was "that's really strange"). 

Looking at my insurance provider they have 275 consultants with the specialism in London on their books. Most operate in central London at times so how do I go from that to deciding on one? Each lists their areas of interest but with not tentative diagnosis I cannot match. I dont know anyone who's seen such a specialist in London for a personal recommendation. 

I really don't think that is acceptable service from the GP. What would they have done if you didn't have private insurance that covered GP referrals? Presumably referred you to a NHS consultant in the area that seemed most likely?

I'd be surprised if your insurance will accept a claim without a more specific GP referral. If so, use that to force the issue and go back to the GP and ask for a NHS referral. Then, if you wish, use that as a stepping stone to go down the private route.

beckstar1975

Thing is you don't sound like you're at full on diagnosis stage yet, so the specialism is the best thing to aim for. It doesn't matter if they don't list your suspected condition, if it's under their specialty that should be enough. And if they're really out of their depth they'll know who to recommend you to instead.

The whole point of specialists is to diagnose when GPs can't, so most people won't go to their first appt knowing their diagnosis, only how it presents. So, I'd just look at a few of their bios and see who you'd like the look of and more importantly where they work from. Some might put they cover a local hospital but that would only be a day a month - def in London anyway. So it can mean a big wait in between appointments.

Just to add (but may not be relevant to you) that I used to struggle ethically with private healthcare. If you see a private medic/have private treatment within an NHS hospital some of that money will go back to subsidise the NHS. A hospital I used to work at had to halt taking on new cancer patients as their private revenue was down and thus the didn't have the fund to cover it that financial year. This helped me feel a bit better. But recognise there are many reasons why people would use private healthcare (and I indeed have it for my own family)

DullGreyGuy

Undervalued said:

DullGreyGuy said:

I'm fortunate that I'm generally in good health and so rarely have need to see a GP let alone a consultant. The couple of times I have needed a referral either the GP has recommended a consultant by name or has had a good idea what's wrong and so could narrow down consultants based on their specialty.

So, been told need to see a specialist consultant but the GP didn't know any to recommend a particular individual and has no idea what the cause of the problem is (the previous GP's official diagnose was "that's really strange"). 

Looking at my insurance provider they have 275 consultants with the specialism in London on their books. Most operate in central London at times so how do I go from that to deciding on one? Each lists their areas of interest but with not tentative diagnosis I cannot match. I dont know anyone who's seen such a specialist in London for a personal recommendation. 

I really don't think that is acceptable service from the GP. What would they have done if you didn't have private insurance that covered GP referrals? Presumably referred you to a NHS consultant in the area that seemed most likely?

I'd be surprised if your insurance will accept a claim without a more specific GP referral. If so, use that to force the issue and go back to the GP and ask for a NHS referral. Then, if you wish, use that as a stepping stone to go down the private route.

They'd be referring me to the department of 18 consultants and likely I'd see one the registrars on the day. For private I've been referred to a named consultant but prior NHS referrals have always been the same by GPs... only if a consultant hands me over (eg changing where I live) have I ever had a NHS referral to another named doctor.

The insurers have preauthorised on the basis of the GP saying I need to see this type of specialist... they haven't seen the letter but then nor have I yet 

DullGreyGuy

beckstar1975 said:

Thing is you don't sound like you're at full on diagnosis stage yet, so the specialism is the best thing to aim for. It doesn't matter if they don't list your suspected condition, if it's under their specialty that should be enough. And if they're really out of their depth they'll know who to recommend you to instead.

The whole point of specialists is to diagnose when GPs can't, so most people won't go to their first appt knowing their diagnosis, only how it presents. So, I'd just look at a few of their bios and see who you'd like the look of and more importantly where they work from. Some might put they cover a local hospital but that would only be a day a month - def in London anyway. So it can mean a big wait in between appointments.

Just to add (but may not be relevant to you) that I used to struggle ethically with private healthcare. If you see a private medic/have private treatment within an NHS hospital some of that money will go back to subsidise the NHS. A hospital I used to work at had to halt taking on new cancer patients as their private revenue was down and thus the didn't have the fund to cover it that financial year. This helped me feel a bit better. But recognise there are many reasons why people would use private healthcare (and I indeed have it for my own family)

I guess I am slightly scarred by the fact my long ongoing chronic medical condition comes under a very wide umbrella specialism. I used to always be seen by a particular consultant who had an interest in my specific condition and when he moved hospital he recommended that I follow him rather than see a generalist in the specialism. 

He gave up NHS clinical work several years ago now and I went back to the wider umbrella meaning I go to a "diabetes and other conditions" clinic and have to explain at least 2-3 times each time I'm not diabetic. Even the registrars have done random things like a sleep apnoea test even though I've never reported an issue with sleeping and no one has ever said its in any way related to my condition. The result was a very mild case, below normal referral level, and they asked me if I was still having the problems or not. It's like, what do I know? I've never had problems as far as I know with sleeping, the test was your guys idea but if its linked to my condition well I've had that since birth. 


So yes, may be over worrying about getting a consultant with an explicit interest in whatever my problem may be.

DullGreyGuy

Thanks, went with option B which was to see which Drs attend regularly and then of the two which have weekly clinics, which could see me first. 

Whilst painful, it's more of an inconvenience than anything life threatening etc thankfully.