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  • FIRST POST
    • textbook
    • By textbook 6th Nov 17, 7:23 AM
    • 146Posts
    • 16Thanks
    textbook
    Using A & E to see a specialist?
    • #1
    • 6th Nov 17, 7:23 AM
    Using A & E to see a specialist? 6th Nov 17 at 7:23 AM
    Do people go to A & E when they feel a GP isn't specialised enough to deal with a problem want to see a specialist in a particular field? I know it should be for emergencies but do people use it for the above reason? Rather than booking to see private specialist/consultant which is expensive.
Page 2
    • Enterprise 1701C
    • By Enterprise 1701C 28th Nov 17, 7:52 AM
    • 19,645 Posts
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    Enterprise 1701C
    This is why A&E is so bogged down.

    It is purely for life or limb threatening illness or injury.

    It is not for people who cant be bothered to register for a doctor, or wait for an appointment, or even ask the right questions at the surgery.

    If people did not go down there for a minor cut or minor illness, then maybe life threatening cases would have better attention. Just think, you go down there with a bit of a virus, you might be costing someone their life, apart from anything else you could pass that on to someone who is extremely ill and it could be the straw that breaks the camels back.

    Personally I think they should have the right to say to minor cases that will simply heal or need no treatment, that they should just go and make an appointment with their GP.
    What is this life if, full of care, we have no time to stand and stare
    • jenniewb
    • By jenniewb 30th Nov 17, 2:48 AM
    • 12,434 Posts
    • 11,656 Thanks
    jenniewb

    Personally I think they should have the right to say to minor cases that will simply heal or need no treatment, that they should just go and make an appointment with their GP.
    Originally posted by Enterprise 1701C
    They do- or they are supposed to if they are not currently. A&E are only there to patch you up and send you on your way with the advice to see your GP if it doesn't get better.
    They are not there to treat, just patch up and make something safe or roadsworthy, you may find people getting scans and whatever to ensure something is safe (eg no broken bones beneath the surface after a big fall or RTA but there would need to be sound reason for a scan of that nature) and even if there is a break, the only "treatment" as such will be making sure it's safe and not likely to break further (so maybe a plaster cast) but in terms of repairing something which would require a specialist and the same for diagnosing something which is not immediate or life-and-death, you'll just get told to make an appointment with your GP so he/she can refer you and have wasted multiple hours in the process. A&E are simply not able to refer you, even if your condition is chronic and built up over time. Unless you are unsafe to go home (very bad pneumonia or something) they wont keep you in to treat you or operate on you but that really does fit the bill of it being an emergency.
    If A&Es are treating things which are not life or death emergencies rather than just sticking a plaster on it (metaphorically or literally), then they are not sticking to the rules!


    It also may be worth noting that quite a few A&Es also run a duty Doctor service. This is not the same as A&E and is basicly a GP based in a hospital and is designed for those who cannot get an appointment or are unable to get time away from work/child care..etc. They can prescribe things like antibiotics and longer term medication (which is unlike A&E), they can't do more than assess, I don't know if they can refer without your GPs agreement (because the funding for that referral has to come from your GPs surgery and they obviously would need the agreement of your GP first to do this- which would not be practical for many reasons. But can contact your GP with the information they have and possible suggestions. They are not the same as A&E but do sometimes sit within A&Es.
    • Red-Squirrel
    • By Red-Squirrel 30th Nov 17, 11:40 AM
    • 2,885 Posts
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    Red-Squirrel
    From what my wife's told me about life in A&E - you're better to see a GP than an A&E doctor, for many things. You won't access a specialist this way either (unless you actually need one to stop you dying).
    Originally posted by ringo_24601
    Yeah, A&E is a great way to see a specialist cardiologist if you're having a heart attack, or a specialist neurosurgeon if you've had a massive head injury, or a specialist vascular surgeon if you've cut your foot off with a chainsaw.

    Otherwise, what you're going to get is sent home and a letter to your GP advising them to refer you if needed!
    • Starrystarrynight1
    • By Starrystarrynight1 30th Nov 17, 7:58 PM
    • 213 Posts
    • 355 Thanks
    Starrystarrynight1
    Do you have an issue with your current GP, OP? Or have you just been listening to silly gossip? If you do have a problem with your current GP, then you should see about registering with an alternative practice whose catchment area you live in.

    If you have something you don't feel a GP can deal with, you are going to need to discuss the issue in detail with a GP first. You might even need to follow a recognised path of initial treatments first before your GP will refer you to a hospital. I read recently that some areas have all their GP referrals sent to a special unit where they're reviewed and it is this unit who decides if the referral can then go forward to the hospital. If this is true, then I'd think as much pertinent information as possible would need to go with the referral.

    I don't know about others, but I was quite angry to read your original post. A&E is busy enough without blatant time wasters. Please do not do this.
    -------------------------------------------------------------------------------------------------
    I used to be Starrystarrynight on MSE, before a log in technical glitch!
    • teddysmum
    • By teddysmum 30th Nov 17, 9:49 PM
    • 9,047 Posts
    • 5,395 Thanks
    teddysmum
    The checking of GPs' referrals was in the media, but I can't remember whether it was in the pipeline or just a recommendation.
    • textbook
    • By textbook 19th Feb 18, 6:22 AM
    • 146 Posts
    • 16 Thanks
    textbook
    GPs are ok for most things but when something serious and chronic but non-life threatening crops up, the UK system isn't great. It might be great in other areas. They are wonderful for many things.


    In most countries you refer yourself to the specialist and preferably a recommended one and one who is specialised in your specific area of problem. Let me illustrate the this, I had prostatitis and was told by a load of Brits (I am British) but lived abroad so can compare our system with the ones abroad that NHS is a waste of time for the condition. You need to see a good urologist who takes an interest in the problem to get anywhere with this. In Britain this is a problem because GPs are not capable of helping you. If you get referred the chances are the urologist can't help you. So you go private well - it costs £170 to see a specialist pricately for 20 mins. What a waste of money! A guy I spoke to with this condition (living in the UK) said the medical system in Turkey is better, what he means is he paid £30 to see a specialist so he could see three before he made progress with his prostatitis. Because of the cost of going privately in the UK many Brits can't afford it. Can you see the problem I am trying to point out?


    Prostatitis is just an example. There are many other conditions where it would be better for me take control and decide who to see about a medical issue, but find doing this challenging in the UK.
    Last edited by textbook; 19-02-2018 at 6:52 AM.
    • pmduk
    • By pmduk 19th Feb 18, 8:39 AM
    • 8,671 Posts
    • 6,437 Thanks
    pmduk
    In the UK you now have more choice over who you get referred to. (NHS Choose and Book) Using a GP means your referral should contain all necessary medical history and notes,

    However, you are so fixated, I suspect that no matter what evidence is presented you'll have friends who know otherwise!
    • adandem
    • By adandem 19th Feb 18, 8:53 AM
    • 3,489 Posts
    • 4,720 Thanks
    adandem
    Yeah, A&E is a great way to see a specialist cardiologist if you're having a heart attack, or a specialist neurosurgeon if you've had a massive head injury, or a specialist vascular surgeon if you've cut your foot off with a chainsaw.

    Otherwise, what you're going to get is sent home and a letter to your GP advising them to refer you if needed!
    Originally posted by Red-Squirrel
    I was sent home from A&E and told to go back to GP over an Easter holiday a few years ago. Not wanting to cause any trouble, I went home with a bag of morphine for the pain.
    I had to get a GP home visit as soon as they were open as o could barely move due to the pain. I was then admitted and required emergency surgery for an ovarian torsion and appendicitis. Both can be life threatening.
    Needless to say I have little or no faith in my local A&E department and it's not always advisable to wait for a GP referral.
    Last edited by adandem; 19-02-2018 at 8:58 AM.
    • C_Mababejive
    • By C_Mababejive 19th Feb 18, 9:59 AM
    • 10,489 Posts
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    C_Mababejive
    The real danger is that if a GP takes a conservative approach to your malady, it might get misdiagnosed due to the limits of the GPs knowledge and lack of diagnostic equipment. You might then advance and be in a worse position when finally diagnosed ie premature death.

    All the kit is at the hospital.

    Do you want to gamble?

    GPs have their own budgets to manage. Maybe they are influenced by this?
    Feudal Britain needs land reform. 70% of the land is "owned" by 1 % of the population and at least 50% is unregistered (inherited by landed gentry). Thats why your slave box costs so much..
    • LadyDee
    • By LadyDee 19th Feb 18, 10:20 AM
    • 3,012 Posts
    • 3,114 Thanks
    LadyDee
    In my area we are very fortunate to have an Urgent Care Centre for "urgent but not life-threatening" and if you can't wait to see a GP or get an appointment immediately it's invaluable.

    Mainly staffed by specialist nurses but a qualified doctor is also on site.

    I've had occasion to use it when I needed fast attention to a nasty wound which in all conscience I couldn't possibly call life-threatening, but certainly needed treatment quickly. Dealt with by nurse, GP is informed by the unit and follow-up care by my own surgery.

    I can't speak highly enough of this service, and coupled with advice from a local pharmacist when needed, even GP visits are kept to a minimum.

    Every town should have one.
    • C_Mababejive
    • By C_Mababejive 19th Feb 18, 11:48 AM
    • 10,489 Posts
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    C_Mababejive
    Governments dont care who dies. It can sometimes make economic sense if certain groups die
    Feudal Britain needs land reform. 70% of the land is "owned" by 1 % of the population and at least 50% is unregistered (inherited by landed gentry). Thats why your slave box costs so much..
    • benjus
    • By benjus 19th Feb 18, 12:06 PM
    • 5,169 Posts
    • 3,186 Thanks
    benjus
    My wife has also found the British health system rather hard to get used to - she's from Argentina and generally prefers the system they have there. I'm not really familiar with how their system works and how it is funded, but she could basically go and see a specialist whenever she wanted to. The system of having to go to a GP to get referred to a specialist was rather difficult for her to adapt to, especially when GP appointments are so hard to get.

    I have a private GP service paid for by work which I see far more than my NHS GP, because I can usually get an appointment the same day, the doctors are on time, and it's very close to the office where I work. My wife doesn't have this - I've suggested that she might be better off paying for it (it's not massively expensive at £30/month for unlimited appointments) but for now she's sticking with the NHS. Of course, if the private GPs prescribe you anything expensive then you'll have to pay the full cost of the medicine.

    I also have private medical cover with work which covers us both for many specialist consultations, although there still needs to be a referral from a qualified doctor (so usually a GP). So things are better for her now than when she first arrived here, but she still finds the whole process a hassle (getting the GP referral, then dealing with the insurance company) compared with what she was used to.

    So I do understand why people get frustrated when they are used to other systems. Not that I would recommend going to A&E to try and see a specialist. And the implication that specialists in this country should charge a similar amount to what they charge in Turkey also seems rather bizarre.
    Let's settle this like gentlemen: armed with heavy sticks
    On a rotating plate, with spikes like Flash Gordon
    And you're Peter Duncan; I gave you fair warning
    • ska lover
    • By ska lover 19th Feb 18, 12:25 PM
    • 2,769 Posts
    • 6,727 Thanks
    ska lover
    Unless your condition is an emergency, you will not get seen by a specialist, you will get seen by a duty doctor, and your gp contacted to make a referral
    The opposite of what you know...is also true
    • Red-Squirrel
    • By Red-Squirrel 20th Feb 18, 11:01 PM
    • 2,885 Posts
    • 7,711 Thanks
    Red-Squirrel
    it's not always advisable to wait for a GP referral.
    Originally posted by adandem
    Well no, obviously not when itís an actual emergency.
    • elsien
    • By elsien 20th Feb 18, 11:10 PM
    • 16,736 Posts
    • 42,224 Thanks
    elsien
    You can see a specialist here any time you like if you want to - you just need to pay for it instead of expecting an overburdened NHS to continue to clog itself up with the worried well. I have a relative who'd work there way through every department in the hospital, given half a chance.

    And with the sleep apnoea example - losing weight is one of the things that will make a difference, so it's not unreasonable of the GP to make the suggestion.
    All shall be well, and all shall be well, and all manner of things shall be well.

    Pedant alert - it's could have, not could of.
    • adandem
    • By adandem 21st Feb 18, 7:57 AM
    • 3,489 Posts
    • 4,720 Thanks
    adandem
    Well no, obviously not when itís an actual emergency.
    Originally posted by Red-Squirrel
    That's the point. Mine was an emergency but A&E still insisted on a GP referral.
    • Red-Squirrel
    • By Red-Squirrel 21st Feb 18, 10:30 PM
    • 2,885 Posts
    • 7,711 Thanks
    Red-Squirrel
    That's the point. Mine was an emergency but A&E still insisted on a GP referral.
    Originally posted by adandem
    That was a mistake, they do happen sadly, it doesnít mean thatís the norm!
    • textbook
    • By textbook 27th Mar 18, 10:08 PM
    • 146 Posts
    • 16 Thanks
    textbook
    My wife has also found the British health system rather hard to get used to - she's from Argentina and generally prefers the system they have there. I'm not really familiar with how their system works and how it is funded, but she could basically go and see a specialist whenever she wanted to. The system of having to go to a GP to get referred to a specialist was rather difficult for her to adapt to, especially when GP appointments are so hard to get.

    I have a private GP service paid for by work which I see far more than my NHS GP, because I can usually get an appointment the same day, the doctors are on time, and it's very close to the office where I work. My wife doesn't have this - I've suggested that she might be better off paying for it (it's not massively expensive at £30/month for unlimited appointments) but for now she's sticking with the NHS. Of course, if the private GPs prescribe you anything expensive then you'll have to pay the full cost of the medicine.

    I also have private medical cover with work which covers us both for many specialist consultations, although there still needs to be a referral from a qualified doctor (so usually a GP). So things are better for her now than when she first arrived here, but she still finds the whole process a hassle (getting the GP referral, then dealing with the insurance company) compared with what she was used to.

    So I do understand why people get frustrated when they are used to other systems. Not that I would recommend going to A&E to try and see a specialist. And the implication that specialists in this country should charge a similar amount to what they charge in Turkey also seems rather bizarre.
    Originally posted by benjus

    It's hard to get used to because it's crap. If I have a worry about my child I want to go to paediatrician not a blase GP who probably got pass for his medical degree. I wanted someone to see my three year old and he recommeneded that nurse who monitors a childs development. What's she going to know about tricky anatomical issue? (That was what I wanted looking at.)

    Not saying Brit docs are bad. They're pretty good- not as good as in the US or France but ok. Other problems are it's all too closed, it's hard know which doctor is good and which one has a trail of malpractice as it's all covered up and hidden. The docs also seem to leave things too much and not be proactive in doing something.
    Last edited by textbook; 27-03-2018 at 10:25 PM.
    • textbook
    • By textbook 27th Mar 18, 10:16 PM
    • 146 Posts
    • 16 Thanks
    textbook
    The real danger is that if a GP takes a conservative approach to your malady, it might get misdiagnosed due to the limits of the GPs knowledge and lack of diagnostic equipment. You might then advance and be in a worse position when finally diagnosed ie premature death.

    All the kit is at the hospital.

    Do you want to gamble?

    GPs have their own budgets to manage. Maybe they are influenced by this?
    Originally posted by C_Mababejive

    Exactly. They are trained to be more conservative and leave things compared to US docs. I just get frustrated being back in Britain after seeing some specialists in the US who were excellent and also who were reasonably priced. Half what it is to go privately in the UK.
    Last edited by textbook; 27-03-2018 at 10:51 PM.
    • textbook
    • By textbook 27th Mar 18, 10:29 PM
    • 146 Posts
    • 16 Thanks
    textbook
    You can see a specialist here any time you like if you want to - you just need to pay for it instead of expecting an overburdened NHS to continue to clog itself up with the worried well. I have a relative who'd work there way through every department in the hospital, given half a chance.

    And with the sleep apnoea example - losing weight is one of the things that will make a difference, so it's not unreasonable of the GP to make the suggestion.
    Originally posted by elsien


    oh come on. The guy had the second worst case of sleep apnoea ever found at the sleep clinic in Brazil!! The Brit GPs saying just lose weight and not identifying his problem is terrible. Typical of them- leave it and make light of itu. In some cases you really have to go out and deal with this yourself and pay money and research who to see.
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