NHS Doctors, what do you think of patients who have gone private and come back to the NHS for ongoing treatment?
Posted by ToughImprovement276@reddit | AskUK | View on Reddit | 407 comments
Genuinely just curious as I tend to get things diagnosed privately and treated privately when acute. When it’s something chronic or that requires ongoing monitoring, my insurance doesn’t cover that so I (try to) go back to the NHS to continue long-term treatment/montioring.
However, whenever I’ve mentioned to my NHS GP or consultants that I’ve been seen privately they’re never overtly disdainful but I always get the impression that they don’t rate it very highly or that I’ve come back to the NHS with superfluous concerns.
For example, a FBC found that I have small blood cells and very high thyroid antibodies. The private endocrinologist I was seeing told me to get that checked out with my GP as I could possibly have anaemia or a thalassemia trait. Went to my GP a couple times and each doctor I saw kinda brushed it off and made a comment that private doctors often check and highlight things that aren’t really important. I’ve had similar experiences with consultants in nhs hospitals too.
So just curious to know what the impression of private healthcare is within the NHS. I’m always a bit surprised because all the private doctors I’ve seen also work on the NHS too and often give me names of NHS consultants in my local trust to continue treatment with.
I genuinely thought it was doing a good thing by going private whenever I could to reduce strain on the NHS.
FearlessPressure3@reddit
I doubt you’ll get many doctors actually commenting here. My experience is that once you get to consultant level (which realistically is what you want of a doctor if you’re going private) those doctors do both private and NHS work. I think the only areas where you’ll get someone doing only private work are very specialised eg tendon repair surgery for sporting injuries. Personally, I went private for my endometriosis surgery two years ago because I was told the waiting list to see a consultant in my area was 18 months and by the time I went to the GP I was in so much pain every day that I couldn’t sleep. I had my surgery within a month of the referral to the private consultant. I do have some guilt because I know that giving consultants private work is one of the reasons the NHS waiting lists are so long, but also, I wouldn’t have survived 18 months with that much pain every day 🤷♀️
Ghotay@reddit
The reason why doctors won’t comment is because invariably every thread like this immediately devolves into dozens of people complaining about some shitty doctor they once saw. I don’t deny anyone their experiences, but as a GP myself it is pretty disheartening when I literally kill myself at work every day for my patients. I’ve read a bunch of comments I could respond to with my thoughts but it just ends up making me angry or upset or both. So I keep out of it
Most consultants actually don’t do private work. However doctors who do private are all consultants, and also all work NHS as well
Small-Ad3896@reddit
As someone who has been through chronic illness and similar experiences to many others in this thread, who now has a absolute star GP who I can tell cares about her patients and works hard - I’m sorry you feel disheartened and likely overworked ❤️ so many of us see and appreciate you, please keep listening to your patients, you are making a difference by doing so.
A lot of us do have an understanding of the system you’re working within 👍 you are seen and appreciated by many 🙏
Blondibee@reddit
And yet one trip to the GP/Doctor subreddits will show how the majority of you really think of us. If you’re the outliner then good for you. The rest are as bad as we’ve experienced.
FearlessPressure3@reddit
Yeah, I get that. I initially studied medicine but bailed after I intercalated because I was hating the rotations and knew the actual job would be so much worse. I went into education instead and end up having the exact same experience when someone makes a post about teachers or schools.
I actually can’t find any recent figures on what percentage of consultants in the NHS also have a private practice. My assessment of “most” is probably pretty old now (as in, I was studying medicine twenty years ago!) but one article in 2000 estimated that 70% did. In 2012 there was an estimate of “about half” but I can’t find anything more recent. I’d be interested to know what the picture looks like, especially post-Covid.
concernedBrit882@reddit
Did you have your surgery privately or under the NHS?
lavayuki@reddit
Im a GP and I don’t mind. Obviously there are instances where we cannot continue the treatment so the patient has to continue to pay for it privately, most common example being ADHD meds where pretty much every practice in my PCN has a blanket no for all private ADHD medication requests.
We would have to do an NHS referral, get them assessed under NHS and establish a shared care agreement. Same goes for other hospital only medications that GPs are not allowed to prescribe, where I can only go by NHS and not private eg anti psychotics, methotrexate etc.
But if it’s something reasonable, I agree with the treatment plan and it is within the scope of general practice then I am fine to continue it under the NHS.
As GPs we have a RAG list of what meds we can and cannot prescribe. Anything red or orange on this list that has been given by a private doctor needs a referral to or advice from the NHS consultant. We normally cannot just give it because of a private letter due to medio legal reasons.
Medico legal reasons, NHS funding and restrictions on GPs regarding certain treatments are the main things that can cause problems when transferring from private to NHS care, sometimes warranting referral again on the NHS.
Forever-Fallyn@reddit
As someone who has to get my ADHD diagnosed privately because of how badly I was struggling - I would love to know why you have this blanket 'no'. The NHS waiting list is 7 years where I live. Would the NHS rather treat me for the mental health issues I'm developing due to untreated ADHD?
Just FYI, I was diagnosed by an NHS doctor who does private work out of hours.
nj_93@reddit
ADHD drugs are specialist prescription only under NHS guidance. Some practices take on shared care for this prescription but the NHS does not give funding for the moniotring required of those drugs. The practices that take this on are therefore doing it for free, of their own free will and will be liable for any harm that comes to this patient in the future due to this drug. Also unlike other shared care drugs, where the patient is still seeing the specialist annually or has contact details of the team if the monitoring done shows it is no longer safe to prescribe the drug - this simply dkes not exist for ADHD. Private companies that diagnose ASD/ADHD can close down whenever and are notorious for not following up on their patient if they don't have to.
Besmirching_Badger@reddit
The drugs are heavily controlled and can only be prescribed by relevant specialists.
Same reason you can't order repeat prescriptions either. Each one has to be ordered individually. And you have to have an assessment every 6-12 months.
They're too 'dangerous' or the consequences too severe legally due to said controls to allow GPs to prescribe them.
It's all a farce, but drugs are bad and scary you know /s
lavayuki@reddit
Its not a decision of the individual GPs but the higher ups or by the practice as a whole. Not too sure of the exact reason but it’s usually medico legal, monitoring required, funding etc.
Imaginary-Friend-228@reddit
The reason is "fuck you" to poor people (from the government, not gps)
Forever-Fallyn@reddit
If coming from higher up the chain makes sense - and to be honest you have given me a better answer than my actual GP did, so thank you.
the_star_lord@reddit
Interesting to hear. As an adult who has recently been diagnosed with ADHD via private health care, and is seeking titration privately, knowing to expect my GP to flat refuse any transfer of treatment kinda sucks, but, I also understand especially if there's been a massive influx of diagnosed people especially adults, I get the wariness to just give out medication.
Personally I feel like my ADHD has been there all along, but , having COVID / lockdown adult stresses etc just pushed me over the edge and made me seek help and then a diagnosis (not that I wanted one)
lavayuki@reddit
Yeah I mean in the past, GPs did accept private ADHD meds requests, but this was in my mums generation (she is retired now) and things are a lot stricter these days, safety being a big reason. ADHD drugs need very careful monitoring, plus there have been some dodgy private ADHD clinics floating about since after covid which are not run by psychiatrists. Not sure if these are still around but I remember it being an issue about 2 years ago. Practices can't differentiate these from the genuine private ones, so many have just said no to private requests.
As for titration, GPs are not qualified to titrate ADHD meds so even if you were diagnosed by the NHS and needed titration, it would be a case of getting in contact with the psychiatrist who prescribed it to you initially.
Inevitable-Spite-575@reddit
The differences in care decisions is crazy to me. I was diagnosed with ADHD privately through ADHD360 about 1.5/2 years ago. My GP accepted my shared care agreement no problem and was actually really enthusiastic about it when I spoke with him beforehand “Absolutely. We’re here to help after all, so let me help. Why wouldn’t I?” I’ve been receiving my prescription monthly through my GP ever since (60mg Elvanse, 10mg Amfexa, 5mg Amfexa per day).
Saying that, I’ve had no monitoring whatsoever in that time, although I did get a call from my surgery last week asking me to go in next week for my “shared care check up,” and I suspect that is only because I had just had my annual review with the private clinic, who then sent their report to my GP.
I am so grateful that my GP is willing and able to do this for me, but I very much worry when I read things like this that it isn’t going to last. My prescription is almost £400 per month if I were to pay it privately, and that is just not feasible for me.
lavayuki@reddit
There is only one practice that accepts private ADHD agreements in my region. They have been scrutinised by the GMC and called out on bad prescribing tendencies. They are always is trouble, no monitoring of anything. Someone I know who works there says it’s a complete disaster and is trying to fix it.
So although as a patient you might be happy, the GMC would look poorly on that doctor as it’s seen as negligent. Medications are not toys, they need careful prescribing and monitoring or patients can come to harm.
deimantek@reddit
what kind of monitoring would the GP need to do for GMC to consider it ‘not negligent’?
i was told if i have any issues to go back to the provider. the GP only insisted on doing annual height/weight/bp checks
lavayuki@reddit
Blood pressure, heart rate and weight every 6 months is correct. Not doing that is negligent. Many drugs need monitoring not just ADHD drugs, and not doing it is medical negligence. All this info is found for each drug in the British Medical Formulary and must be followed.
deimantek@reddit
diagnosed via NHS or not, shared care is only transferred to the GP after titration so all the GP has to do is sign for the same prescription every 30 days
curious if you’ve heard of blanked bans for shared care other than adhd?
Imaginary-Friend-228@reddit
You shouldn't be understanding, you should be angry that your government has abandoned poor people
weeurey@reddit
What is the reason that the NHS seems to be doing blanket bans on Shared Care for ADHD? I went private for my diagnosis and paid the considerably high cost for this due to the NHS psychiatrists being overwhelmed with work atm and I was diagnosed by a NHS ADHD Specialist who was working privately for ADHDDirect. From my laymens POV I have done the NHS a big favor by not clogging up the referral queue and all they have to do now is prescribe the meds that I am now stable on.
Luckily my total meds cost is only around £50 a month but I am already paying a considerable amount of NI so I shouldn't have to be shelling out for it.
I hope this doesn't come across as me having a go at you, I'm just trying to understand the system
lizzypeee@reddit
I completely agree. We went private for an assessment for my son. He was 7 years old, already diagnosed with autism and an EHCP and the ADHD medication has been transformational for him - he probably wouldn’t still need in mainstream education without it.
We tried to set up a shared care agreement but were refused. Forcing us to go through an NHS diagnosis just to tell us what we already know seems like a total waste of resources in an already massively overstretched system.
Imaginary-Friend-228@reddit
Double diagnosis wouldn't be so bad if they could hurry the fuck up
Imaginary-Friend-228@reddit
Its so bizarre to me because from a purely capitalist perspective, people who have their ADHD treated hold down jobs betger
PhotographShoddy2846@reddit
I don't know the situation now, but my GP agreed with the Shared Care no problem. However, I was diagnosed under the NHS, it was just the medication that I went private for ... after waiting for 18 months for nothing because they put me on the wrong list, and when I let them know, they said I had to go back to the bottom of the wait list. No real hate, I am also an NHS cog, but yeah, it can be frustrating in situations like this.
weeurey@reddit
What county are you based in? Guessing your England?
PhotographShoddy2846@reddit
Yes.
AlpineJ0e@reddit
You might find some of the reasons here helpful.
Direct_Instance_8655@reddit
Very helpful, thank you. As a GP, do you have a view on the NHS's stance to not accept many private scans etc? E.g., I had private maternity care but was transferred to the NHS at 31 weeks pregnant (not my choice). They refused to accept any of the various scans (6weeks, 7weeks, ..., 12 weeks, etc) showing the baby's age and instead insisted on rescanning at 31 weeks when it is incredibly hard to correctly assess the baby's age. Despite me showing them all the scans they preferred changing the age to almost a week less. It just made no sense to me?
disneyadviceneeded@reddit
This may be due to the fact that “sonographer” is not a protected term in the UK. In any NHS setting your sonographer will either be a midwife or radiographer with at a BSc, at least a few years experience plus postgraduate study and training.
Now I’d hope for the kind of money you paid, this would be the same in a private hospital. But it legally doesn’t have to be, so whoever your care was transferred to would’ve had no idea whether this was a highly trained midwife/radiographer or not.
Direct_Instance_8655@reddit
Yes sure. But the person doing the scans would have been listed on them with I don't know many titles (and also working for the NHS). As the NHS person doing the scan, would you not at least have 'quietly' factored in the many scans provided and based the estimate on that? By all means do an extra scan for the sake of it if they must. Dating the baby younger instead of acknowledging that development had stalled was a more dangerous thing to do?
swansw9@reddit
I do a lot of ultrasound and we have a list of criteria we have for a private scan to ‘accept’ it as part of the investigation pathway. Some of the stuff is incredibly basic like it needs to include the patient’s full name and the date of the scan. It also needs to include the clinician’s name and credentials. Surprisingly many private scans do NOT include this information, let alone the full clinical details that we’d need. So for a lot of private scans we have to disregard their findings and start from scratch. It’s possible that this is why your pregnancy scans weren’t considered, or the hospital may have a blanket policy based on bad previous experiences!
disneyadviceneeded@reddit
As I said, the staff at the NHS hospital could’ve checked with the hospital about the sonographers qualifications (there’s not even a register so they would actually have to check with the hospital themselves and clarify). I’m not saying it was right in your particular situation, but I’m just explaining why majority of NHS hospitals have a blanket ban on accepting private scans.
Ok-Nobody6221@reddit
I had my due date amended based on a non NHS scan but it was done by the fetal medicine doctor rather than the sonographer. I had my first few scans as I was abroad and then came back to the UK at 14weeks pregnant, the scan at 14 weeks dated baby a few days younger. At a scan at 27 weeks with the fetal medicine doctor baby was measuring on a bit of a higher percentile so I mentioned that baby had previously been dated a few days older so they had a look and amended the due date back to the original one. I've heard that even moving between NHS trusts in middle of pregnancy they will redo the scans and tests because each trust has slightly different rules and guidelines
Direct_Instance_8655@reddit
Ok fair enough, thanks. Seems a bit weird but on the other hand it probably means they also all know it's not that accurate anyway and it thus doesn't make such a big difference
lavayuki@reddit
I personally don’t have an issue with private bloods and scans and will look at them, but I wouldn’t be able to treat (eg prescribe) or refer based on them (I can do a referral but the hospital usually rejects).
I did have one time where the hospital did accept a private MRI scan of a patient , however it is rare and many seem to refuse and request an NHS scan which takes ages.
As for bloods we always have to request them again. Unfortunately we can’t go by private tests due to variations with labs etc and also medico legal reasons. So if a patient gets a private test that shows a thyroid issue, I have no problem repeating the blood test and taking it from there.
I don’t have a negative view of private healthcare. I completely understand that the NHS takes an age, and it’s fine for patients to use it. But the NHS just has a lot of rules and funding restrictions, and doctors are scrutinised and watched by the medical council making it difficult for the two systems to work together.
Direct_Instance_8655@reddit
Thank you, appreciate the response. I guess ultimately it all comes back to the fact that healthcare overall in the UK is set up with a functioning NHS in mind.
ToughImprovement276@reddit (OP)
This is very interesting to know in terms of the medications you can’t transfer back to the NHS but it’s fair enough!
ReinforcedTube@reddit
Laboratories have to be accredited and tests taken and sent appropriately. Many labs are in a bit of a grey area as to their standards and whilst the results are probably in most cases accurate, the tests may still have to be repeated using an NHS lab. This is particularly the case for investigations done abroad where there is no evidence of the quality control in the lab. Same thing applies to other diagnostic tests. Some will be happy to accept, others wouldn't. I'd be skeptical of many private tests ordered off the internet, particularly the ones done at home by finger prick.
ToughImprovement276@reddit (OP)
That’s fair, I probably wouldn’t accept the results of tests ordered off the internet or in these high street wellness places that seem to be popping up all over the place.
I do wish there was some sort of accreditation scheme for these things though. I’d like to think that the HCA labs attached to the private hospitals are reputable but if they’re lumped in the same boat as a random internet test which is analysed God knows where, then yeah I understand the hesitation.
notanadultyadult@reddit
I paid for a private health check up through Randox. Basically an extensive blood test which tests loads of different things. It highlighted my thyroid numbers were way off (hyperthyroid and antibodies). When I phoned my GP to discuss the possibility of me having a problem and needing to be addressed, she said “well what do you want me to do about it?” and “well I didn’t do those tests so I don’t know if they’re correct”. I had to push for her to do a thyroid test to confirm. Lo and behold, I have an autoimmune disease which required referral to an endocrinologist.
Some doctors (I feel like the older ones) don’t like it.
My hairdresser did the same testing I did after I told her about it. She took her results to her GP to discuss something and he (a younger doctor) was completely interested in her full results, not just the one she was concerned about.
SpooferGirl@reddit
My GP always replied exactly the same whenever I’ve handed him paperwork from private doctors. ‘What do you want me to do about it?’
I’m still never sure if he’s actually asking because he’s offering to help, or whether it’s a dismissal, but I lean towards assuming the negative so I’ve always said ‘nothing, just add it to my medical records so it’s noted’. Then at some future time I might refer back to it and request a referral or some other help, but never at the appointment where I’ve given them diagnoses to add. The only one he’s ever seemed receptive to was my autism paperwork.
Sweetlittle66@reddit
I think you should treat that question sincerely. Regardless of their feelings about private testing, they still need to know what action you want them to take.
SpooferGirl@reddit
I think it’s his face when he says it that puts me off.
throwawaynewc@reddit
As a doctor, the idea is whoever ordered the tests are responsible for reviewing the results and guiding management or referral.
Giving the test results back to the patient and saying, here go see your GP is poor practice really.
Intelligent-Day-5161@reddit
Going private because a doctor won't help is the reason. A doctor further not helping just exacerbates things.
Far-Presentation6307@reddit
But they have a doctor - the private doctor who they saw.
Kittibean@reddit
Most of these private labs are taken by companies that literally just do the labs.
Far-Presentation6307@reddit
So who requested the tests then?
One of the key principles of medicine is you don't request tests unless you know why you are doing the test, what the different results mean, and how to manage them.
Normally a doctor will request a test to answer a particular question. If there is no doctor and you just went and ordered a load of tests then YOU are the one responsible for dealing with the outcome. Normally that would mean referring yourself privately (yes, at your own expense) to the relevant specialty.
callisstaa@reddit
So be rich or be sick? This is what people are understandably trying to avoid.
Far-Presentation6307@reddit
They get free healthcare at the point of use. These private tests where they test every blood marker possible are a dangerous gimmick, and the NHS should not be on the tab for dealing with the fallout.
If they requested the tests privately, then they should deal with the results privately.
Agile_Media_1652@reddit
Most people go to private consultants in desperation and using money pulled together from family, friends or credit card.
You are aware of the costs of a private appointment are you not?
How many do you think can afford follow ups or ongoing medication privately.
It's all fucking money, money, money now to doctors and avoiding any kind of liability whatsoever. Treatment the patient is not a concern anymore.
Sweetlittle66@reddit
Ok but are there actual symptoms of concern, or did they just get a test because it was on offer, found something outside the typical range and then went to their GP?
The purpose of the NHS is to treat actual ailments, not to ensure everyone's test results are within a given range.
super_sammie@reddit
I don’t deserved any less care from the NHS because I saved them money and got the underlying (often privatised anyway) work out of the way.
My private healthcare actually paved the way for a negligence claim against the NHS for a life altering and (if I’m honest) life reducing missed diagnoses.
A doctor who has taken the oath is not there to decide the financials or the how things can happen. Only to treat the issue I present them with. If I show up to an NHS doctor with a full diagnoses and have done all the hard work…. It’s their duty and my tax’s problem to help me.
pineapplesuite@reddit
If you don't mind sharing, what was it the NHS hadn't spotted? I'm really sorry you've gone through that. I know how utterly draining it is trying to get answers.
Boom_doggle@reddit
This is going to be a bit of a downer, but my mum had this. She wasn't feeling well, and recognised the symptoms as cancer. She'd had it twice before by that point and went to the doctor who insisted she was fine. For nearly a year she kept pushing and pushing but they wouldn't do more than a cursory check. Eventually it got so bad she paid for a private scan. Stage 4 cancer, dead 4 months later, mid sixties.
To the NHS' credit, when presented with the results they stepped up care and she was looked after well for those 4 months. I don't think it was genuine malice, but a chronic funding shortfall. Doctors weren't given long enough to diagnose her, and god knows what treatment would have been available. We need to take some lessons from Norway: they have a publicly funded NHS too, and theirs seems to run better and cheaper!
Unsoftened_Reality@reddit
This is why we need a fully interoperable NHS with seamless private integration, a single national patient record, universal diagnostic standards, system based responsibility wider adoption of AI safety nets.
throwawaynewc@reddit
Agreed
AutomaticInitiative@reddit
My private health insurance through work will do things to a point, but they don't do long term management of conditions. They would diagnose thyroid insufficiency and stabilise it (for example) but expect long term treatment to be done within the NHS. Just private test results is a symptom that the person has probably been dismissed by their GP before.
IanM50@reddit
Private health insurance is useless, multiple testing tends to find more false positives than actual problems, which is why the NHS doesn't do it, and they will never cover you for stuff you already have or for anything long-term. They just want to make a quick profit.
AutomaticInitiative@reddit
Mines through work and covers cancer treatment so wouldn't say useless.
throwawaynewc@reddit
Sure, they can refer back to the NHS but it needs to be done via a formal referral.
scoschooo@reddit
wow so shitty. so as a doctor you resist helping the patient because someone else ordered the tests. You can read the test results as well as anyone. You can treat your patient.
Give me a valid reason you can't read test results yourself, and help the patient? The person is there in front of you for a reason.
If that is standard practice - I don't want to help because another doctor ordered the tests, then that is really bad for patients.
segola92@reddit
Your logic is completely off.
The responsible doctor should have justification for why they have ordered a particular investigation, because any investigation has an element of harm to a patient (e.g. loss of blood, radiation exposure etc). Its also very bad practice to order an investigation, discover an abnormal finding and then put the onus on the patient to find a doctor to follow up on the findings. What the doctor should do is act on the findings and refer to the relevant hospital, clinic etc
Its hard to act on random blood tests taken in isolation, by a company you have no idea about, relating to a patient you likely havent examined yourself recently. Its worse when the patient themselves are the one asking you to act on rather than recieving the referral from the doctor.
Its not just GPs by the way, if you went to a hospital and showed up at an endocrine department showing off a random bloody test by Randox and asked one of the doctors there to act on it, you would be told that you would only be seen if you had a referral
scoschooo@reddit
Why are you ignoring what I was talking about. You are a doctor, you have a patient in front of you, you have lab or test results, and you try to not treat them because you didn't order the test. That is not good for the patient. Who said anything about the doctor who ordered the tests?
I was reply to this:
If the poster meant in general, that is one thing. If the commented meant they wouldn't help their patient because someone else ordered the tests, that is very different - and not good for the patient. If it is in your area of expertise, and you can read the lab results, then help the patient - not try to get them to go see someone else.
So talk to the patient. You can't pretend every blood test or lab test will not indicate a problem. You can get more information and history.
The idea that you won't help a patient because someone else ordered the test, and not you, is awful.
But I get that there is a system that people want to happen - the patient works with just one doctor who ordered the test.
BrillsonHawk@reddit
Yes , but the issue is getting to an nhs GP in the first place. It's better since I moved where I live, but in my old town it was virtually impossible to get an appointment with a GP. The only way to get seen was to go private and then hope they refer you back to the nhs, because most people aren't millionaires
taknyos@reddit
My GP referred me to a specialist and said the waiting list is 4 years, and actually recommended paying for a private consultation to skip the queue.
I paid for the private consultation (had it within a week) with the same specialist (he works both for the NHS and for a private firm). He then suggested switching me back to the NHS so I could save money on the tests he recommended.
Paying privately is sometimes the only realistic way to get seen.
It's borderline impossible to get an appointment with my GP since covid too. I'm sure a lot of people are suffering in silence. And that will only result in much greater stress on the NHS when conditions that could have been treated early and left to fester and then be much more costly to remedy.
PuzzleheadedFun663@reddit
I have private insurance and now I'm always very reluctant to use it for something that could potentially be chronic because I feel like I'd be royally screwed . Because my health insurance only covers acute conditions, so things won't be covered, but it takes a couple of visits to convince my GP to do further tests
superhorsforth@reddit
Oh if only that were true. I was diagnosed with a sliding hernia in an NHS hospital, but I have a stage 4 hernia with my whole stomach and part of my colon in my chest. So glad I went to a private doctor for a second opinion.
cityfrm@reddit
You get a doctors summary of their interpretation if your results with the companies ive looked at.
My GP wasn't interested in infertility and loss. I paid £350 which included a doctor referral for bloods, then the results came with a follow-up explaining I had APS. After spending so much on IVF, this finding has changed the course of my treatment and my chance of having a family. I wish I'd done it many years sooner, but the GP never suggested it.
notanadultyadult@reddit
Yeah in a way I get that. I could have paid additional for them to provide a private GP service but as a standalone product, it’s just the blood tests. And they do provide some explanatory notes. I’ve gotten pretty good at reading my thyroid test results now that I know I have an autoimmune disease. And because when I go for my thyroid checkup at the GP they only test TSH and tell me I’m fine, I’ll occasionally pay for my own thyroid blood work to track and keep and eye on my levels.
Ok-Fun119@reddit
The people are going private because the NHS won't do it are looking to pay as little as possible, they won't pay for a private consultation ontop of labs.
sosig_roll@reddit
Within medicine, ordering tests (such as those the practitioner from Randox did in your case) and then not appropriately following up on the results (in your case starting treatment, I presume for Graves disease/other hyperthyroid condition, and onward referral) is considered poor practice and terrible treatment of your colleagues (in this case your GP).
It's easy to order every test under to both cover your arse from missing anything, all the while. exposing your patients to significant risk (false positives leading to excessive invasive investigations, radiation etc). Oh and ordering investigations privately obviously makes money.
Long story short in your case your private provider should've done better and frankly we're either lazy or incompetent given they didn't act on the results of the tests that they ordered.
notanadultyadult@reddit
The private provider isn’t offering a GP service though. I get what you’re saying if they offered that full service (which they do separately but not with the package I chose). It’s a standard package with 150 biomarkers.
sosig_roll@reddit
A standard package with 150 biomarkers is exactly the sort of reckless over investigation I'm talking about though.
False positive rates for investigations are commonly 5%. If everyone aged 20-60 (ie working age) were to go and have the same panel done that you had, there would be hundreds of thousands of further, unnecessary biopsies, CT scans etc that would all yield negative results.
For every X number of ct scans, someone gets cancer. For every X number of biopsies, you puncture an organ/artery requiring surgery/causing significant morbidity, etc.
The false positive rates of tests goes down when you have clinical suspicion because you are essentially combining different tests (eg the blood test and your clinical exam/history).
gundog48@reddit
I'd hardly call it 'reckless'. The test itself doesn't incur any risk to the patient.
Under-investigation is extremely common and can be just as reckless. Patients are often aware that something is wrong, but aren't able or qualified to identify it, and GPs are often reluctant to investigate anything apart from the more obvious and immidiate.
I don't think that getting a blood test is an unreasonable course of action from a patient in that scenario to try and narrow things down and see if anything warrants further investigation.
If certain numbers are abnormal, and could be related to your symptoms, that gives you a place to start. I'd expect that in such scenarios, it would be sensible for the GP to order a blood test to confirm the results. If they're still abnormal, it absolutely warrants investigation, but confirming the results only requires a safe and routine blood test which seems reasonable and proportional.
Yeah, there's false positives in any kind of testing. Most people taking them aren't just doing it for the sake of it, they do it because they have a reason to, and the alternative is very often the GP doing nothing to resolve it.
When an issue is actually known, then doctors can make reasonable decisions on interventions and balancing risks, but getting to that point can be really difficult, and I don't think false positives are a reason not to investigate.
sosig_roll@reddit
The poster that I responded to was in a different situation to that which you describe.
They describe themselves as having no symptoms, just ordering a battery of tests because because they want to keep track of their health.
I agree with you that if you have symptoms and you aren't getting anywhere with your GP, or waiting times are terrible, you should advocate for yourself or your loved one and if that means seeking private work up that is absolutely fair.
I just don't think private providers should be making battery's of tests available to asymptomatic patients, especially unless clinicians from that private service are willing to follow up appropriately on positive results (which could include appropriate NHS referral).
gundog48@reddit
That's fair and I did have that in mind reading your comment. I broadly agree that doing blood tests 'out of curiosity' isn't worthwhile, and I'd hope that they'd be treated by the GP as a single data point. If there are no related symptoms where there 'should' be, I'd expect most GPs would make a note and not recommend any action.
The issue to me really is that restricting who can get a test like this will effect everyone using these tests and introduce similar problems with gatekeeping, and is likely would introduce more problems than it will solve.
Although I've not encountered it, I do disagree with advertising these services as 'MOT's that should be done routinely/out of curiosity and would support banning that practice. It's more that I think that people shouldn't be denied access to tools to investigate their own health, even if it's not appropriate for many people who seek them out.
Otherwise_Leadership@reddit
I don’t understand. You say you disagree with promoting a broadband MOT blood test, but then say people should have access to tools to investigate their own health. Can you clarify?
gundog48@reddit
So, I'd argue that something like taking out an ad encouraging people to take tests routinely when they have no symptoms is unproductive and kinda predatory. Especially as it could be sold as being 'responsible' which implies it's irresponsible not to. So I wouldn't be opposed to restrictions on how services like this are advertised, beyond current trading standards.
But, I think these services should be available to anyone willing to pay. Actually restricting the services or forcing the need for some kind of 'valid reason' would do more harm than good and just brings back the exact issue that people have with GPs that these services can mitigate.
Fundamentally I don't think it's right to deny people the ability to investigate their own bodies in such a harmless way, I make use of these services regularly as I'm on HRT, others use them to investigate symptoms their GP is unwilling to investigate, there's many instances where these services are valuable and I think trying to restrict access will do way more harm than good.
The important thing to me is responsible messaging, there's a fine line between offering services like these and going after the 'already healthy' market by preying on anxieties.
notanadultyadult@reddit
I like to keep track of my health and so these tests were a good way for me to identify any issues (Grave’s disease) and act appropriately on it. I had little to no obvious symptoms despite being extremely hyper.
Some of my test results were borderline and things that I may want to keep an eye on for future reference but I didn’t go running to my GP about those. Of course this does depend on the person. I like to think I’m quite clued in and medically minded but I understand not everyone is like that.
Isn’t having an awareness of your own health a good thing. That way you know what to work on to improve your overall health going forward. Healthy people are less of a burden on the health system after all. Or do you want us to stay sick?
sosig_roll@reddit
By all means, you do you, but I don't think you have actually understood/listened to anything I've said.
There are plenty of great private health care providers out there who I have happily received patients from while working in secondary NHS services. Invariably the ones that just blindly order tests like this are unhelpful for both patients and the NHS.
But let's agree to disagree.
Otherwise_Leadership@reddit
Putting aside the issue of “who tests, treats”, if I came to you as a reasonably healthy early 50’s male wanting a general health check - prevention better than cure - what would you say to me?
sosig_roll@reddit
Fill your boots/I'd fill them for you. It's literally a thing (Well man check) that's promoted by the NHS. But it doesn't check 150 different things, it checks key risks for that demographic.
djdndjdjdjdjdndjdjjd@reddit
I get you think there’s a wider policy issue but this person has a result which was way off normal, should they have just ignored it?
sosig_roll@reddit
No of course not. But the healthcare provider that provided the test should act upon the result.
_milfhunter__69@reddit
Paternalistic BS
cris_j@reddit
What utter nonsense. If this is the way the NHS 'thinks' then no wonder people are going private in droves.
panth141@reddit
One side of this to consider (which doesn't apply necessarily in this case, but does in many) is that the route for further clinical treatment down a private pathway comes with additional costs that are significantly higher than the test. So you may get a private test that isn't offered routinely by your GP/has waiting lists etc. and be able to afford that - but if the next step is to spend hundreds or thousands on further private treatment, that may be unaffordable.
In these cases it seems reasonable for your GP to take the test results (if they're reputable, accredited etc. - not all are!) as a significant enough indication that they should offer the patient access/referral to the relevant NHS pathway. Often this includes retesting rather than trusting the private lab's results - fine - but a 'I can't help you' reply when a patient has a result that recommends further investigation doesn't seem like great care.
These cases are such a GP lottery. Often if the GP is interested in the area or keeps abreast of new developments, they will see what they can do. But frequently there's a blanket 'wasn't done by us, can't help' policy - either because they don't want to be or can't be flexible (see large group-led practices) or don't want to be (stuck in their ways, too much of a ball ache).
Hot_College_6538@reddit
It's not ethical for this company to offer testing without appropriate follow up. While in this case it helped detect something important, I bet there are lots of perfectly healthy people getting concerned over irrelevant results but consuming GP time.
It also kind of feels like if there was a queue for NHS testing this is using your money to jump the queue, to the disadvantage of other people in the queue. Like people with fasttrack passes at Legoland. I'm not sure there is really a queue for blood tests on the NHS though, never had any delay with my GP ordering necessary tests.
Less-Contribution-35@reddit
It’s not just that there is a long wait for tests - especially for women, it is often (very very often) the case that we are told we are worrying about nothing and there is. Refusal to send us for a referral. Very very often we have to shell out for a private test and then hope against hope that the gatekeeping GP will take on board these test results, proving what we’ve been trying to tell them, and make the appropriate onward referral.
Hot_College_6538@reddit
There aren't long waits for NHS blood tests in my (extensive) experience, which is what are talking about here.
There's also a difference between a doctor determining that a test is appropriate and just having a battery of 150 tests on an otherwise heathy person.
Less-Contribution-35@reddit
You surely are shitting me? There is an infinite wait if the doctor refuses to send you for a blood test. Which is the actual point I made here.
Sweetlittle66@reddit
If the doctor refuses to send you, that's not any kind of wait, that's the doctor recommending no action. Whether that's correct or not for a given case is rather a separate question, and the first course of action ought to be a second GP opinion (NHS or private).
Yes GPs are human and not all of them are good at dealing with weak signals. But the guidelines on testing are evidence-based with a view to causing minimal harm to patients.
Hot_College_6538@reddit
You said
in a thread about blood tests. There is not a long wait for NHS blood tests.
Airportsnacks@reddit
I was anemic and was told to take iron tablets. Every single NHS website says there should be a follow up blood test to make sure the anemia has resolved and to take iron three ish months past that point. I have asked my GP multiple times about a follow up test and have been told that I've taken the iron so I'm fine now and there is no need for a follow up test. It's a basic blood test, not even a complicated one.
panth141@reddit
I agree, but it's hard to nail down what 'appropriate follow up' is and who is bearing the cost. If it only requires a consultation with a doctor to talk it through, then that's a totally reasonable expectation on the private provider. If the follow up is further testing (often scans) or medication and monitoring etc. - then the cost of that is going to be significant. And if the patient can't afford that, they're in a crap situation.
I'm sure you're largely right that waiting lists aren't too relevant for blood testing. More often it's that they just don't (yet) have access to this testing - NICE/MHRA are slow. But you can end up in situations where a patient has a significant result from an accredited, validated test with fantastic sens/spec/PPV/NPV etc. and the next step/treatment is something that is offered by the NHS - but it isn't offered to the patient because the GP won't acknowledge the results.
Some private providers offer written (pseudo)referrals to the GP or sometimes even to specialist NHS referral units - these may get a bit more traction. Indeed the specialist units are often more receptive as they are well informed and usually aware of these tests. But it's still a lottery based on the interest of the GP/specialist who receives it.
Hot_College_6538@reddit
It's unfortunately just not ethical to offer this type of service, should not be allowed.
It also breaks the Hippocratic oath of medicine to do no harm. Unwarranted testing will inevitably lead to harmful treatment for false positives.
Some people just have high thyroid levels no doubt, the patient in this thread might be one of them and is now receiving treatment for conditions that would have never caused them any harm.
gundog48@reddit
Strongly disagree.
For example, I'm trans. NHS treatment is appalling bordering on dangerous at times, as the patient, you have to take a lot of responsibility for the quality of your care. Part of that are getting hormone tests done, which the NHS simply don't bother doing, even though it is the most important indicator of effective dosing, and not checking them is broadly considered irresponsible.
This is probably a more unusual case where they are happy to take the results at face value and let it inform dosing. If you don't advocate for yourself like this, it is very common for people to be dangerously underdosed and for nobody to be aware of it.
Sure that's an edge case, but GPs are generally very reluctant to investigate conditions that don't present a clear picture. Yes there are false positives in any testing, but that's a bad reason not to do it imo. GPs are not expected to take the results at face value and start chopping bits out of you. I imagine the first follow-up would be to do another harmless blood test to confirm the results, then choose what's appropriate.
Your comments pretty much ignore the ethical issues of underinvestigation by GPs, especially for those with less externally-obvious symptoms, and you kinda assume that all these are false positives or unnecessary.
Doctors are good at interpreting results and deciding on the best course of action. The difficulty is getting to that point. I think the idea that a routine blood test is going to be more harmful than ignoring issues is pretty flawed.
I only really take issue that you think it 'shouldn't be allowed', that would certainly be a big issue for me and a lot of others, and deliberately puts people more at the mercy of referral gatekeepers.
Less-Contribution-35@reddit
So can you talk me through the scenario I outlined above - the GPs by their thousands that don’t take proper notice of, for instance, women with menstruation or fertility issues? What about their Hippocratic oath? Because I absolutely GUARANTEE you that they are far more prevalent than some private testing service. And again, the reason people don’t continue down that pathway is because they couldn’t afford the test in the first place and certainly can’t find the money for anything more on top of that.
Hot_College_6538@reddit
Sounds like you need to complain about your GP or find another one, this isn't the experience everywhere.
Less-Contribution-35@reddit
Just here, only a few posts below this one. A kid who could have lost their life from a missed leukaemia testing.
https://www.reddit.com/r/AskUK/s/XJv4izVkm9
Are you a bloke by any chance? Because I think you are perhaps talking from a place of immense privilege.
Airportsnacks@reddit
Or this little girl who died of Type 1 diabetes when a very cheap, very simple. very fast blood test would have shown what the issue was. 'Lyla's Law can be lasting legacy for our daughter' - BBC News
panth141@reddit
I think 'unwarranted tests' was a jump here and certainly wasn't what I was talking about - so perhaps we're thinking about different things. While there are of course snake oil salesmen and rubbish tests (see 23&Me's awful, low coverage versions of carrier screening!), there are also very robust, clinically validated tests whose results are meaningful - and my view is they shouldn't be discounted by GPs.
GL510EX@reddit
I read that the first time as your hairdresser was the one who took your blood tests, and wasn't surprised your GP dismissed them!
sadsack100@reddit
Well my hairdresser diagnosed my underactive thyroid. She bluntly informed me that my hair was falling out and she'd noticed the weight I'd put on. She then confidently announced, "I reckon your thyroid's fucked." Obviously I told my GP that my hairdresser had already made the diagnosis. He found it quite funny.
notanadultyadult@reddit
I’ve successfully diagnosed my husband with several things well before the doctor has. He was once in hospital for a week before they figured out what was wrong. I had it clocked on the second day lol.
Lopsided_Soup_3533@reddit
I diagnosed my husband correctly with shingles
lovinglifeatmyage@reddit
Lol I did that with my brother. GP told him it was an allergy rash
Key_Plum_99a@reddit
I diagnosed my husband with measles in 2017, he said his skin was irritated and took his polo shirt off, he was covered in a very close spotted red rash (he was born before the NHS vaccinations started in 1970).
Luckily everyone we know he was in contact with was vaccinated.
Vaccinate your kids!
lovinglifeatmyage@reddit
Same here, took 2 drs to mis diagnose my husband, I googled his symptoms and came up with a diagnosis. I have a nursing background so realised he was having a reaction to some medication
JammyRedWine@reddit
I diagnosed myself correctly with coeliac disease. My GP congratulated me and I gave him some good natured grief about me doing his job for him!
Tulcey-Lee@reddit
Probably easier to get an appointment with your hairdresser than the doc as well!
okizubon@reddit
I like the idea of hairdressers having to do a year or two of medical school before they can cut your hair.
Zeddith@reddit
Some have picked up skin cancers have heard to be fair!
Rogue_Tomato@reddit
It's crazy what you can notice through your hair. I've heard of hairdressers knowing people are pregnant through the thickness of their hair.
Sean_South@reddit
My hairdresser told me why my hair was falling out after a covid infection in 2021.
Telogen effluvium.
Smeee333@reddit
Hairdressers are often the first to know as you stop dyeing your hair too.
Indigo457@reddit
Funnily enough, barbers and surgeons used to basically be the same professional body lol
ThrowRA_significant1@reddit
My eyebrow lady was the one who told me about my thyroid as my eyebrows were falling out!
sadsack100@reddit
Yes, I remember the outer edges disappeared. That wasn't too noticeable though as I have very blonde eyebrows.
kecksonkecksoff@reddit
I saw a video where a hairdresser knew immediately that her client was pregnant due to changes in her hair texture/colour and it goes to show that when you see someone regularly they can really notice the details
Metrobolist3@reddit
Barbers used to be surgeons so why can't a hairdresser be a phlebotomist?
everythingsoon@reddit
My hairdresser actually is a phlebotomist as well!
darybrain@reddit
I read it as Radox so wasn't surprised about the hairdresser after a hair wash and facial
Turbulent-Quality-29@reddit
I had the opposite with Randox though TBF the GP were really good. It was some test everything type thing and it had I had way over on a random mineral I think it was, googled it and the main cause was a genetic disease which can be very problematic as you age. Anyway I just emailed the GP asking if it was worth double checking. Got a reply next morning, blood test booked within a week and results within 2 days considering it was Christmas week.
Seemed like Randox was erroneous as theirs was totally normal. (I have a bit more faith in NHSBT).
mousecatcher4@reddit
There are a lot of desperate people who are going private because the NHS basically isn't there for them. But the Randox type screening is just a load of nonsense -- charging vast amounts of cash for stuff that would cost pennies or just a few pounds in any NHS lab - and throwing up all sorts of nonsense (that's what non-thinking screening does) that someone else needs to deal with.
notanadultyadult@reddit
Well when it caught something that could potentially have been fatal for me, you’ll see why I don’t fully agree with that thought process.
ilovethatforu@reddit
I think they don’t like the blood tests because sometimes they flag issues that aren’t really there. Everyone has variation in their results and if you aren’t experiencing any symptoms or have any concerns then it can cause you a lot of stress to find that your numbers are off. Obviously in your case you did have an issue and it’s a good thing you got it checked.
notanadultyadult@reddit
Yeah I totally get that. I had some results that were borderline but I figured they were fine. My thyroid function was off the charts hyper though. Funny thing is, I wouldn’t have said I had any symptoms. Nothing glaringly obvious.
Looking back, I guess there were subtle symptoms but I just thought they were normal. Like the constant figure (thought all adults felt this tired) or the weight loss (I was trying to lose weight anyway so thought my diet and gym routine was working lol).
DigitalStefan@reddit
Had a mate who had thyroid issues. Made him into a complete moody bastard for a while until he got it diagnosed and then the treatment levelled out. He didn't notice symptoms because who would ever think being cynical or quick to anger was a symptom?
Brain stuff is weird.
Mysterious-Mountains@reddit
Brain stuff is weird, complex and misunderstood I was also cynical and quick to anger for my whole life. Started HRT for a different issue and suddenly? Full of the joys of spring, stopped antidepressants, annoyingly chipper
notanadultyadult@reddit
Oh yeah. I have that too lol. But I think that’s just me in general haha.
Necessary-Crazy-7103@reddit
Yeah and then you're "in the system" to be monitored which might mean excess work/resources being spent that isn't necessarily needed.
The_Right_Mistake@reddit
It’s kind of crazy because the NHS is under such pressure you would think they would be happy people are going private and taking some of that burden off them…
drmax1988@reddit
These sorts of testing doesn't decrease the burden on the NHS, rather increases it. Asymptomatic patients having tests for biomarkers that often have unclear clinical significance creates more work for GP, more anxiety for patients and occasionally harm due to false positive results and onward invasive tests. If you have symptoms see your doctor. Screening tests in asymptomatic patients are rarely beneficial.
ZebraCrosser@reddit
Not if they don't do the appropriate follow up but create more burden by shoving that to the GPs who now get to spend a lot of time educating worried people about false positives and how those slightly off values that were tested with no clear clinical question aren't clinically relevant to their health.
I've ordered a lot of blood tests but it's always for a clear clinical reason to look at specific things, either related to a certain complaint or to follow something up. Not just tick every box and see what sticks. Ticking 20 boxes is a big order, even with that including some compounded tests I might still only get 30-40-ish separate test results. I can't even think 150 tests that would be relevant to request in the general population.
The_Right_Mistake@reddit
Understand what you’re saying. I guess there are different levels of ’private testing’ here also.
ZebraCrosser@reddit
Probably. I expect there's a difference between going to a private clinic for a specific issue and testing related to that and getting a long list of blood tests because they're available from someone who advertises it on the tube.
Mind, when I worked in the UK it was a specific corner of health care where NHS vs private didn't come up much, and I now live somewhere that has a different system. Atm when it comes to testing I mostly just don't want any colleagues to request a d-dimer for my patients and leave all communication and follow-up to me. 😂
xxxxxxxxxooxxxxxxxxx@reddit
Patient advocacy seems to just not be a thing within the NHS.
vagabond_bull@reddit
It’s worth remembering that the quality of medical professional varies hugely, like any other professional. There’s a tendency to assume a level of competence and care that doesn’t always exist.
I’m not saying to ignore the doctors advice - but if some thing isn’t sitting right with you, or that advice is contradicting what you’ve read or heard elsewhere - push for clarity and answers, or seek a second opinion.
AffectionateJump7896@reddit
I think there is a difference between seeing a specialist and actually having the condition diagnosed then the long term treatment being handed back to the GP, and having some vague tests done and asking the GP to figure out and fix the real problem.
The former is basically the GP specialist interaction anyway, and a core part of general practice is to take back long term treatment from specialists.
The later, if everyone did it, would have every GP being asked to look into thousands of anonymous test results every day, when only some tens really need any action. The result is that hundreds then might end up with the side effect of treatment. There are many screenings that aren't offered by the NHS if they are inaccurate, result in over treatment etc.
PomPomBumblebee@reddit
My friends child was poorly and wanted blood tests as this kid never got sick.NHS GP just fobbed it off and said they might do blood tests but no rush
Got them done privately to move things forward and was found to have leukemia.
Always go with your gut.
notanadultyadult@reddit
Oh my goodness, that’s so scary. I’m glad your friend trusted their instincts and got the diagnosis and treatment sorted. Must be so hard knowing your child is sick.
PomPomBumblebee@reddit
She's a dental nurse and knew her kid well enough that something was wrong.
She has always been very pushy and good with me getting seen if I'm ill at work
TheBlakeOfUs@reddit
I did a similar thing where I paid for a blood test because my doctor didn’t believe me that I had low testosterone because I’m muscular.
But I knew that all of my new symptoms matched testosterone
So I paid for a private blood test to do my full panel which showed eventually that I had a problem with my pituitary gland which was stopping my body from creating enough testosterone, and as such my oestrogen level was near zero, which explained why I felt so weak and couldn’t sleep.
The doctor then sent me for five more identical blood tests because he still didn’t believe them.
Took me nine months to get treatment, which I had to go private For.
stormy_councilman@reddit
Which test did you pay for if you don’t mind me asking? Been interested in getting something like this done for peace of mind.
notanadultyadult@reddit
I did the everywoman test (there’s also an Everyman test too). It includes 150 data points from blood work done plus you get repeat testing in 6 months included in the price. Also, have a quick google, you can normally find a discount code for around 10% off.
orange_fudge@reddit
It’s just a culture clash.
Private dockets are in a culture where they investigate everything and treat preventatively. They are looking for optimum health.
NHS doctors work by guidelines where anything within a wide ‘normal’ range isn’t routinely investigated or treated. They are working towards a baseline of good enough health.
KeyJunket1175@reddit
culture clash? Doing things right vs. being forced to make concessions is not a matter of cultural difference. I don't think anyone has a culture of choosing subpar treatment.
Direct_Instance_8655@reddit
Maybe "culture" isn't quite the right word. But I think the comment is right in the sense that the NHS does the best it can with the amount of money it has. A private doctor's approach to this is different, they will do what is in the individual's best interest. Not what is in the entire population's best interest.
Digginginthesand@reddit
Not true. Private doctors are under pressure from a paying patient to do more investigations and to prescribe more liberally, avoiding "watchful waiting" Prescribing safe, low harm drugs might seem like nothing but there's no such thing as no risk.
For example inthe UK the commonest use from what I can see is telehealth appointments to get antibiotics. People think doctors hoard them only to reduce resistance but antibiotic use is also linked to increased rates of colon cancer.
In the USA for just one example there's huge overprescription of levothyroxine for subclinical hypothyroidism (you see it here too from some private physicians). The USA's largely private model reveals what we risk.
Cakeo@reddit
I know 2 doctors in the NHS and I could never do what they have to daily. Subpar treatment is an insult to the people that literally keep people alive for fuck all compensation. The NHS makes hard decisions every day and unfortunately not everything can be a priority.
bunnymama7@reddit
Fuck all compensation?
Cakeo@reddit
Tell me how much money you'd want to work unsocial hours, long shifts, dealing with disgusting pish and when you're not doing that you're dealing with members of the public.
I remember a post complaining about how abrupt their doctor was in prescribing vitamin D and told them to go outside, going on to accuse them of racism.
One of those doctors had a guy that cut his dick off with a bread knife.
I'm sorry if you'd do it for less, I personally wouldn't. Moany cunts and traumatic injuries does not sound like a good job to me.
bunnymama7@reddit
I'd want at least £50k base plus more for overtime / unsociable hours
I_Heart_Otters@reddit
👏
Direct_Instance_8655@reddit
No one is saying it isn't hard for the doctors in the NHS. No one is saying they aren't doing their best. It diesn't take away from the fact that the NHS - as you say yourself - has to make tough decisions every day. A private doctor does not have to make these tough decisions every day.
Cakeo@reddit
It's not subpar treatment though in my opinion, it's proportional to the urgency. Going private is fine, obviously you will receive better care, but frankly the NHS could free up a lot of time if people stopped going to them for shit that your body will solve itself.
Direct_Instance_8655@reddit
I think I partly agree with you.
I think both is true: a lot of people go to the NHS with basically nothing of significance. But I think it's also true that a lot of people genuinely receive subpar treatment by the NHS (waitlists etc). It's just not the same people in these two camps. I think the NHS would still be underfunded though even if all the minor ailment people stayed at home. Which just makes you wonder if it can ever be a functioning system in its current form. (And no, I'm not advocating for a US system before everyone goes bonkers).
KeyJunket1175@reddit
No it's not an insult to the people. It's an insult to the system. I literally spelled out they are forced to make compromises. I am sure most people will be trying to do their best, even the person I got to meet at my last GP appointment, where the best he could do is Google my symptoms and take a picture and promised to email a doctor. I am sure he would have done more if he could, but that doesn't change the fact that the treatment and the experience is subpar. Getting offended when people complain and coping with it by pointing the finger at places where it's even worse is never going to provoke any improvements.
Cakeo@reddit
Maybe I have misunderstood you when you have said subpar work?
dospc@reddit
It's not the doctors! It's the funding and management system they have to work in.
orange_fudge@reddit
I agree - I think the NHS has very clear guidelines on what to treat and when to treat it, and I've been fortunate to have excellent doctors at both the GP and hospital level.
Even so - I've struggled to find NHS treatment for the sort of preventative healthcare that I want. For example, physiotherapy to prevent injury, or supplements to address sub-optimum but not dangerously low levels of certain minerals, and I've been happy to pay for these privately.
sprucay@reddit
As a bit of a devil's advocate, I don't think what private health care does is necessarily "right" or "the best". Over intervention has it's risks, and when it's profit driven the line between "it's necessary for health" Vs "this will increase my profits" is blurry. The NHS could definitely do with being more preventative though.
orange_fudge@reddit
I agree - I think there's a medium between the two that we could aim towards. For example, the evidence shows that over-screening for cancer leads to overdiagnosis, which leads to invasive interventions that result in worse outcomes at a population level for those being screened.
orange_fudge@reddit
I don't mean 'cultural' in the sense of US vs UK. An organisation also has a culture which can be different to another organisation. Eg: a business vs a charity will operate different because of the commonly held, shared assumptions that each holds about its purpose and ways of working.
The NHS is a public sector culture. A private doctor is perhaps a more commercial culture.
gl_fh@reddit
I'm not sure that's the whole story.
I think it is quite common to have holistically worse care privately in this country, slightly perversely because it is too dependent on people's whims.
Over investigation is a real thing, and there are treatments that will make symptoms better, but be significantly worse in the longer term.
dowhileuntil787@reddit
It's less of a culture clash in most cases, more just a different set of interests depending on who's paying.
The NHS is trying to maximise the number of quality/disability adjusted life years across the entire population for a fixed cost, you are trying to trying to improve your own wellbeing and will spend more or less money depending on its value to you.
Cosmetics-related healthcare is an obvious example of where the NHS interest and personal interest don't align, but there's all sorts of trade-offs the NHS makes that don't really make sense personally. The NHS has less to spend on, say, bowel cancer screening in the young, because that same money would save more lives if spent on screening for lung cancer in smokers. If you don't smoke but eat a lot of processed food, or just worry a lot about bowel cancer because your friend died of it, maybe you'd rather start bowel cancer screening at 30 even if the population-level risk analysis doesn't support it.
The NHS doesn't really want to spend the huge long tail of costs associated with making everyone go from feeling OK to feeling great, because that money could be spent on making people go from dying to not-dying.
This isn't a critique of the NHS or government-funded healthcare, but everyone should always bear in mind that government-funded healthcare is not there to do what makes you feel better, as such, it's for the health of the country as a whole. Often those align, but often they don't.
Separately, there are differences in how young doctors and older doctors were trained. Doctors now are taught to be more of an expert advisor and the value of shared decision making, whereas older doctors were taught to take on more of a paternalistic role. Personally I prefer younger doctors.
Digginginthesand@reddit
Screening programs are good examples of why this can be a problem.
Routine bowel screening (fit test) relies on finding slow-growing, bleeding adenomas. Those are vanishingly rare in young people. Aggressive, fast growing tumours are more common and those are harder to detect on screening. People still need to act on symptoms. If you're talking about colonoscopies then you're introducing risk, with about 3/1000 having complications. So it potentially leads to harm and probably won't catch even the very rare cancers that do occur in the age group.
Cervical screening is another. Ok, you can test for HPV but 90% of HPV before 30 clears by itself and it takes a very long time to develop into cancer.
I had a friend in another country who attended a private gyno at around 20, long ago, and had a cervical ectropion. Smear sent, abnormal cells, colposcopy, CIN1, repeat, still CIN1, LLETZ. All private. Years later she struggled to conceive due to cervical stenosis. An ectropion and CIN1 are common and usually benign in women that age, if she hadn't been tested she'd never have known and it almost certainly would have gone away by itself.
On-demand, private investigations are frowned upon by the medical establishment for a reason.
orange_fudge@reddit
I agree completely. The different interests and priorities of each sector lead to diverging cultures where the experience of NHS care can be quite different to the experience of private care.
Mouse_Nightshirt@reddit
As a doctor, that is absolute nonsense.
We do tests in the private sector because you've asked for them and then we get paid to do them. Prevention isn't done in the private sector because it's what's needed, it's done because there's a charge for it, and random screening (eg, yearly private MRIs) are nothing more than a money spinner.
The level of care for what's actually needed is essentially no different, at least from the doctors side.
Academic_Isopod_6190@reddit
Also a doctor in private sector and can confirm. This is pure nonsense: A patient ask for tests to be done. In the private sector that gets done whether its clinically indicated or not because the patient is paying for it. 9/10 the result will require no further action, but you'll spend a lot of time reassuring perfectly well patients that the minor derangements in irrelevant parameters in their blood tests are clinically completely meaningless in a well person. 1/10 it will flag something that needs action, and then that patient says "this would never have been found in the NHS". Actually it would have done, but it would have done when it was clinically indicated and not before, and they won't have to waste time and resources explaining to the other 9/10 well patients that there's nothing wrong with them. That's the only difference.
Taken_Abroad_Book@reddit
Often years, if not decades after symptoms appeared and were dismissed
kickimy@reddit
For some diseases "when it's clinically indicated" on the NHS may only arise after lots of irreversible damage and suffering though.
My relative did genetic testing for ancestry purposes and randomly found out she had a genetic disease - haemachromatosis - so was able to get treatment for iron overload before any extreme complications had arisen.
Meanwhile there are NHS patients who end up with cancer, heart attacks and other nasty consequences due to delayed diagnosis.
https://barcankirby.co.uk/delayed-diagnosis-of-haemochromatosis-led-to-liver-cancer/
Academic_Isopod_6190@reddit
But you're comparing apples and oranges. You're relative was incredibly lucky and found a potentially serious underlying genetic condition before it caused any symptoms, by sheer chance and completely incidentally, while not seeking any medical investigations at all. That's not a set of circumstances which is even remotely comparable with something at completely the other end of spectrum: a delayed diagnosis in somebody sick and getting sicker, and making repeated presentations to their GP over years for investigations and treatment.
EhDinnaeEvenKen@reddit
My mum died because her cancer was repeatedly and routinely dismissed as menopause symptoms for over a year as she worsened.
By the time things finally progressed to her finally getting an MRI because of seizures, she already had systemic metastases and lasted barely 4 more months.
If it wasn't for NHS doctors being stingy with testing and referrals, and specifically older male doctors still fobbing stuff off as "womens issues", my mum might still be alive.
lacey_nightie@reddit
i was only referred to a surgeon to remove my endometriosis after I had an episode of complete bladder blockage/needing a catheter (bladder tube). I turned out to have stage 3 and it had already started damaging my organs.
Years of complaints about painful sex, extreme periods and bloody pee weren't enough for more drastic action apparently....
kickimy@reddit
It was already causing clinical symptoms but fatigue and joint pain are typically fobbed off as 'part of the ageing process' in older women. She was lucky to diagnose herself before she got irreversible damage to her heart and liver. Her forum is full of people who suffered for years before getting a diagnosis.
lacey_nightie@reddit
getting this treatment from doctors live on reddit is insane work lol
sisterlyparrot@reddit
yeah the fact that they said ‘any extreme complications’ and the doctor read and responded to that as ‘any symptoms’ really sums up my (and many people’s) experiences presenting chronic symptoms to doctors
Imaginary-Friend-228@reddit
Back pain seems to be a great example of this. Basically come back when you're incontinent but don't skip work or become reliant on pain relief in the meantime and don't you dare get fat from the lack of activity.
Sweetlittle66@reddit
I know someone with chronic back pain who has been to private doctors about it. For many types there's no good treatment but it can be managed with strength-building exercises. "Don't get fat" would be a rude way to say it, but it's factual that extra weight will make it worse. Yes people are busy, and need to work, and it's not easy to do strength training exercises every day. But that is literally the best option.
Adorable_Click_7071@reddit
Very concerned that this is your mindset as a doctor. Will be locating your IP address and reporting you.
FlaviousTiberius@reddit
Watch out, hackerman is on the case!
TazerZXI@reddit
Also I would have thought the NHS would be interested in prevention too?
Sure, they don't want to do unnecessary procedures that waste money, but if you can catch and prevent a problem before it becomes major that surely saves more money than having to foot the bill for long term ongoing treatment.
VeryAwkwardCake@reddit
yes, but there's a point at which the money may be better spent elsewhere, and indeed at which you are actually increasing patient harm overall anyway (e.g. unnecessary masectomies from screening for breast cancer in women for whom the harm of a masectomy times the likelihood of a false positive is greater than the harm from cancer times the likelihood of actually having it)
RedTheWolf@reddit
As someone who just survived breast cancer, thanks, in part, to quick NHS screening and a full mastectomy, I can assure you that nobody is performing unnecessary mastectomies on women, simply because they attended for screening!
And I'm not even sure how you would get a 'false positive' from a surgery which is designed to remove a cancer *which is proven by biopsy and multiple scans to be there*. Please stop spreading misinformation.
tepig37@reddit
I had frequent issues with my breast. But because of NHS guidelines (assuming one had started smoking at 18) i wasnt eligible for biopsy or any Indepth screening.
I remember when the ultrasound drs were looming they were shocked at how they looked because for my age it didn't make sense. When i told them id been smoking since 14 they said it made sense then
Kindly-East-751@reddit
The NHS was actually founded for preventive care. It's much cheaper to prevent something than treat it. Hence why we have vaccination and screening programmes. The thing is it's now so overwhelmed with treatment and lack of funding that it no longer has the resources to do what it was designed for.
Imaginary-Friend-228@reddit
Yes but the more this two tier system exists, and the more the NHSis defunded, the more the NHS just becomes and emergency and cancer treatment service.
drmax1988@reddit
You mean like primary prevention statin therapy, national screening programmes for cancer, health checks over 40 and public health measures (smoking ban, ban on junk food in schools)...
dowhileuntil787@reddit
Don't disagree that whole body MRIs are just a private money spinner.
However, I'm sure you are aware that some things aren't funded by the NHS even when they do have a clinical benefit after taking into account risks and side effects - but where that clinical benefit isn't worth the cost. As an individual, you might have a different view on that trade-off. Also the government is just very slow moving, and specialist in the field often recognise the value of something many, many years before it gets funded for wide access (such as with GLP-1s and the lp(a) test which will inevitably be rolled out much more widely in the future, seems like bowel cancer screenings will probably end up being started a bit younger at some point too).
End result of this is there absolutely care cases where there is a clinical benefit by paying privately for some screenings, drugs and vaccinations that don't yet receive public funding, particularly if you're not the average patient cohort that the intervention was assessed against or have a very different value system from the average person. It's far more rare that the NHS won't provide a surgery with a measurable health benefit. Non-medical interventions are in a weird area because they often do provide a benefit, but the cost of them can be so absurdly high relative to that benefit, they don't get much funding and end up so oversubscribed that you basically can't access them - but still, that does tell you something interesting about how perception of benefit differs from measurable benefit.
On the other hand, you're not exactly getting unbiased advice from a company founded by tech bros that sells screenings either. Unless you've got so much money that you can pay a team of independent medical specialists to look after you and make informed individualised decisions, your best bet is probably usually to stick with the NHS recommendations, which are generally very good. The best "preventative healthcare" that almost nobody follows is just eat healthily and exercise. No amount of questionable supplements or CT scans will make up for a sedentary lifestyle and diet of kebabs.
aliaaenor@reddit
My mum ate healthily her whole life and exercised frequently and maintained a healthy weight. She never smoked and rarely drank alcohol. She did everything we are told we are supposed to. She still ended up dying of cancer because the GP kept dismissing her symptoms as anxiety.
Healthy eating and exercise obviously have benefits, however they do not guarantee that you will never get sick.
Genetics are probably the biggest thing that affect health, more so than lifestyle. Then socio economic status, then stress. This constant dismissal of people's symptoms and blaming weight and lifestyle choices (without investigating the causes of said lifestyle choices such as lack of time and money) is just moralising and guilt tripping in another form. It's the modern day equivalent of victorian moralising about the 'undeserving poor'. It allows people who do have the time, money, energy and other resources to feel morally superior and allows people to write off others and judge them for getting sick, creating more stress and guilt for those who do get sick. It stops people seeking treatment because they are scared they will be judged.
I can still remember my mum sobbing and saying she didnt know what she had done to deserve it and analysing her diet and everything else. No one should feel like that.
It's unscientific, self righteous, old fashioned and reductive, and it helps no one.
Imaginary-Friend-228@reddit
Everyone knows anxious people are immune from all physical ailments
dowhileuntil787@reddit
Nothing guarantees you won't get sick, unfortunately. A friend of mine was vegan and cycled every day, but had a stroke at 50 - meanwhile my grandad was a 60/day smoker for most of his life and is still alive at 90 now - yet his twin died in his 60s of lung cancer. Life is still a roll of the dice.
Genetics is indeed a huge risk which is why taking a family history has always been considered extremely important, but due to pressure to squeeze more appointments into a smaller time it's not being done as thoroughly now. Cheap tests that measure genetic factors are starting to become more available now, which have the potential to revolutionise some aspects of care - lp(a) that I mentioned being an example, as a large non-controllable risk factor for cardiac disease. Many screenings are controversial in medicine because
However. A lot of the screening models used in healthcare are very simple and weak, just based on simple regressions over a handful of factors. New machine learning techniques are starting to make their way in that have much more accurate results that take a lot more factors into account and derive useful predictions from tests that previously would have been pointless. Doctors are somewhat resistant because many of them are black boxes, but the tide is turning.
It's very unfortunate your mum received awful care, but in all honesty, it's not really that much to do with the system of healthcare or screening, so much as there just being quite a lot of shit doctors who dismiss symptoms (and according to studies, women are more affected, although not exclusively). In theory on the NHS you do have a right to see another doctor, but in practice it's obviously a lot easier to choose the particular doctor you want when you're paying. But any system must, by definition, ration the best doctors in some way - given there are limited doctors and, all else being, equal everyone would want to see the best doctor. Self-payer systems do it by money, insurance and government systems do it half by need half at random. The sad reality is, anyone who works in healthcare, anywhere in the world, knows doctors and nurses that they'd never let near their family. I said in another comment that I personally prefer younger doctors as they tend to work more cooperatively with the patient rather than the older traditional paternalistic doctors - but there are amazing older doctors, and awful younger doctors too.
Having said that all that, the fact remains - a healthy lifestyle is still the best controllable factor any of us have. It won't work for everyone, but it gives you the best possible chance.
Mouse_Nightshirt@reddit
Absolutely, and that's where gaps between private and public health systems have their peak difference. It's why NICE have always done things (correctly in my view) by QUALYs (quality adjusted life years), as there is a finite amount of money in the system and you have to go for the best bang for the buck. On the whole, I think they get it right with the resources they have.
The NHS focuses on being good for society, and occasionally the individual falls through the gap. For me, that's the only real role of private healthcare in the UK. All of the rest of it is "nice-to-have-but-it'll-cost-ya".
JustUseDuckTape@reddit
Yeah, there's way more money in testing and "prevention" because you can provide it to healthy people too. If all you do is cure people, not only have you limited your market but every success makes it smaller.
orange_fudge@reddit
I didn’t say I wanted private MRIs or random scans.
But, as an example, I get a yearly skin check from a private dermatologist because I’m Australian and both my parents had skin cancers that disfigured them and nearly killed them both.
The NHS has been great when I have had a suspicious mole, however, I’d prefer to be more proactive in preventing a skin cancer.
In Australia a full body skin check is routine GP care - in the UK that’s obviously not a priority at a population level, so the NHS doesn’t offer it. As an Australian it’s a priority for me, so I pay for it privately.
That’s not a moral judgement on the NHS. I understand why this is the way it is, and I’m not suggesting it should change. But it’s an example of where private practice can offer better, legitimate preventative medical care than the NHS can.
PercySmith@reddit
Been scrolling for ages for an actually answer from a doctor, thank you!
Imaginary-Friend-228@reddit
No they are looking for maximum profit. Treat easy or non existent cases then send back to the NHS for the costly care
MinimumSilver5814@reddit
Private doctors and NHS doctors are usually the same person.
Apple_phobia@reddit
LMAO I love the internet because you just get a bunch of people like you who say a load of rubbish to appear informed but make yourself look like absolute idiots in the process
GalacticDoc@reddit
As a doctor I′d argue the opposite! Private GPs and consultants will often fix the easy stuff for maximum payment and send all of the annoying and difficult stuff our way.
I have also had to stop meds given out to patients for example propranolol given to someone with asthma and I have to explain the reason why.
I have also had patients turning up expecting x,y and z because the private doctor told them they needed it but expect me to action it all and put my name to it when it was not appropriate or evidence based.
Messka85@reddit
Well don't you want the easy cases taken care of so you can dedicate more resources to the more complex ones? Seems like that would save the NHS heaps of time and cash
GalacticDoc@reddit
Really? Perhaps you could have a think about what you are proposing.
LettusLeafus@reddit
Every private doctor I've ever seen also works in the NHS. They just have more leeway to investigate more when they're in their private practice.
orange_fudge@reddit
Correct - and many doctors who work across both sectors are frustrated by the limitations of each.
I never said NHS doctors can’t treat patients in the way that private healthcare does. Instead, NHS treatment guidelines focus or narrow their treatment options and the range of conditions they’re able to treat.
Kenzo86@reddit
I am a doctor. Don't listen to this guy. I provide better care than most private physicians i know and am not driven by cost of private care
orange_fudge@reddit
I agree that NHS doctors are excellent and I’ve had overwhelmingly good experiences. I never suggested otherwise.
There are, however, things that private medicine offers which the NHS isn’t able to provide.
For example, two things I pay for privately are sports medicine / physiotherapy when I don’t have an active injury, and full body skin checks when I don’t have a particularly suspicious mole. I also see a specific endocrinologist who specialises in the overlap of menopause, AuDHD, and chronic fatigue (because I am not, in fact, a guy, and because these conditions are not well provided for in the NHS).
I’m not saying the NHS should provide these things. However these are three examples where private medicine is happy to offer more extensive investigation and treatment. I don’t need any of them and could probably function just about well enough without them… certainly well enough that the NHS would not see these as a medical necessity. But they help me move through the world more easily and live more healthily with less pain, more energy and a greater capacity to contribute.
wogger22@reddit
They're looking for optimum profit. Don't ever think otherwise. Even if the doctor has your best interests at heart they work within an organization that is for profit. They wouldn't be providing services if it made them a loss.
zipitdirtbag@reddit
The NHS works on preventing ill health as well. It's cheaper for them and better for the patients.
Direct_Instance_8655@reddit
Why is it better for the patient?
azlan121@reddit
Because developing a chronic condition sucks, doubly so if it could have been caught and treated early, or even avoided altogether.
As an example, if you can catch someone showing signs of prediabetes, lifestyle changes may be enough to avoid it fully developing and requiring long term medication (or dealing with the consequences of diabetes), similarly
Direct_Instance_8655@reddit
Yes, thank you for your response which I completely get. I misinterpreted the comment above and thought it suggested that preventative measures by the NHS are better than those offered by private care. So ignore me. Fair enough on the down votes ha
orange_fudge@reddit
Sorry... are you asking why preventing ill health before it is a serious issue is better for the patient?!
Direct_Instance_8655@reddit
No!! But that explains the downvotes! I understood the comment as to say the NHS is better at preventing ill health than private care!
Direct_Instance_8655@reddit
It's a genuine question (to anyone who is downvoting me). Why is it better? Is your assumption that NHS doctors are better, or is it financially better for the patients? Or something else I can't think of?
zipitdirtbag@reddit
Not getting a disease is better than getting a disease and being treated for it.
Unlucky-Jello-5660@reddit
Then why do they dismiss anyone under 50 as if they are faking it until they are at deaths door? That's not very preventative?
ToughImprovement276@reddit (OP)
This is an interesting point and might be articulating what I’ve been experiencing.
A lot of the time the private docs tell me that I should keep monitoring something or get something else they’ve found investigated because it *could* lead to something else and I think that’s where the resistance from my GPs at least comes from.
orange_fudge@reddit
Exactly. NHS doctors are generally trained to treat things when they are a current concern, not things that might go wrong in the future.
There are of course some preventative things in the NHS but as a general rule they won't preemptively treat something until there's a direct link to a potential illness/injury.
pointlesstips@reddit
The culture clash is absurd as in many cases it's the same doctors. Any private diagnosis made by a doctor that is still contributing to NHS should be taken at face value ans not dismissed like they often do, eg in the case of mental health diagnoses.
sgt_Berbatov@reddit
I had an operation on my arm done privately. I had lost feeling in two of my fingers and my grip suffered. I thought going private would be better, I'd get done quicker etc.
It's been 18 months and I've not really recovered. I've not seen the surgeon/"specialist" who dealt with me. It's not bad enough to go back to the NHS to sort it because the nerve is damaged and it has to heal. But I can say with my hand on my heart private healthcare in this country is poor.
As an aside, the specialist I seen separately who did the nerve conduction survey used his NHS email for private patient communication. That really pissed me off.
Normal-Associate6788@reddit
My impression is that if you're not coughing up dying, then they don't want to encourage any train of thought that might lead to further treatment. This might be due to most GPs in the UK are privatised, I imagine they're incentivised to refer as little patients as possible. Once you're past the GP phase, everyone's fine.
ForArsesSake@reddit
For the doctor I saw privately my appointments were always after 5pm as he worked for the NHS during the day so I would hope he wouldn’t be disdainful of himself, or me.
ImaginaryParrot@reddit
Same. A lot of them are NHS doctors!
Ghotay@reddit
The fact that people are praising their private experiences and lambasting their NHS experiences, while acknowledging that it is the same doctors, simply proves that it is the broken system we’re working in that is the problem, not the doctors themselves
Jebble@reddit
We always say "It's great once you're past the admin and waiting".
Academic_Isopod_6190@reddit
Exactly. Same people, same skill set. In one system they have the freedom to work as they wish. In the other they don't. And that correlates directly with the patient experience in those systems.
anomalous_cowherd@reddit
My glaucoma consultant is the same. Privately he's very responsive and I had my initial appointment in three days which probably saved my sight. My NHS "emergency" appointment with "one of his team" was eight weeks away at best. I was on a stable medication dose and had had two operations by the time that was due.
mew123456b@reddit
I have a good friend who is a neurosurgeon. He spends two days a week in theatres, one day NHS, one day private. He says in the private hospital he usually operates on 6-12 patients a day, depending on the complexity. In the NHS, best he has ever managed is 3. The organisational capability just isn’t there to do more.
Parking-Pirate8628@reddit
I’m pretty sure almost all of them are NHS doctors.
Jebble@reddit
At St. Thomas when you pay for a private maternity suite, your midwives are the midwives that just ended their shift the floor below. You're paying 15k for a birth whilst getting literally worse care because they're exhausted.
Due-Presentation4344@reddit
Yep, they have to work a certain % of their hours for the NHS I believe.
doesnt_like_pants@reddit
They don’t, doctors can go work full time private practice if they like.
Most who do private work also do NHS work because they feel like they owe the system that taught them and it also helps keep their professional development and networking up to date.
Due-Presentation4344@reddit
Yes my mistake
MrReadilyUnready@reddit
Not at all. But an NHS paycheque is stable and regular. Private practice income fluctuates. Very few doctors generate enough regular private practice to fully leave the NHS.
Due-Presentation4344@reddit
Yes, my mistake. MIL works at Nuffield and said something to this affect but you’re right.
Emilyeagleowl@reddit
Yep! I paid for a private specialist who also worked for the NHS but would have been really difficult to see without paying. My gp’s believed me then and sent me for some further tests
marktuk@reddit
Same experience. Pretty much every private service I've used has been NHS staff doing it as extra money in the side. The only exception was a few private places, but they took on NHS patients as well (which the NHS pays for).
GalacticDoc@reddit
My practice does evening clinics to 7:30m and all NHS.
orangemonkeyj@reddit
This is exactly it. Most of them are consultants and surgeons by day in the NHS and do private work on the side or as a split. The money is better and facilities nicer.
I always say, you’re paying for speed and better coffee in private healthcare. You’ll ultimately be seen much quicker, which is helpful if you’re concerned you have something more serious going on, but you’re not getting more expertise or necessarily better care.
attilathehunn@reddit
That's not quite right. I have long covid and myalgic encephalomyelitis. The NHS guidelines have no treatments for any of these so ones only option is to go private. If you go to the doctor and saying you have long covid they'll likely just give you antidepressants and CBT.
orangemonkeyj@reddit
Interesting. I’m very happy to be corrected and I agree there are gong to be examples beyond my field (ENT) and associated professions.
attilathehunn@reddit
I suppose for very mainstream medical issues they'll be both NHS and private options, with some of the same people doing both. But for areas which are still sometimes experimental (like LC/ME), its only private. None of the meds I'm getting are backed by randomised-controlled-trials so understandably the NHS wont be paying for them. For example low-dose naltrexone seems to help a lot of people, and its very safe at the low dose, but you can only get it privately.
Mysterious_Week8357@reddit
My sister has a long term complex condition.
Often the doctor says ‘the waiting list for an appointment is X months. However I can see you privately next week’
Odd_Leopard_3206@reddit
I would argue that something was genuinely abnormal and potentially harmful most GPs in the NHS would investigate it further, but thing people don’t always realise is that random tests in people who feel completely fine are rarely help and often just make everything more stressful. When someone is asymptomatic, the chance of finding something meaningful is tiny, and the chance of finding something confusing or misleading is much higher. That’s why the whole idea of pre-test-probability matters so much in medicine, even though most patients never hear the term.
If blanket testing genuinely worked, every GP’s life would be unbelievably easy. You’d just order every scan and every blood test for every patient, and the diagnosis would pop out like a receipt from a machine. But that’s not how medicine works. Most conditions don’t have a single clear test, and many results are vague or overlap with dozens of different possibilities. Something like an ESR is a perfect example. A raised level could point to infection, autoimmune disease, cancer, anaemia, inflammatory bowel disease, rheumatoid arthritis, giant cell arteritis, or simply be normal for someone’s age. Without symptoms to anchor it, it’s basically impossible to interpret.
This is why the history is still the most important part of diagnosing anything. The clinical history is about 80% of making a diagnosis. Tests are there to support the thinking and confirm or rule out suspected diagnoses, you can’t start with loads of tests and work backwards.
People understandably remember the one time a GP didn’t order a test and something serious later happened. But they don’t see the thousands of times where symptoms settled on their own, or where testing would have caused more harm than good.
And the harm from overtesting is real. It’s not just theoretical. One odd result leads to another test, then a scan, then a referral, then a biopsy, then a camera and suddenly someone who was perfectly well is being treated like a patient with a problem they never actually had. Incidental findings are incredibly common, and once they’re found, they’re almost impossible to ignore. That’s why screening programmes only exist when a condition is common, the test is accurate, and early treatment genuinely changes the outcome. Incidental finding are common even on NHS tests and are usually just normal variants.
If someone has no symptoms, how many tests would you need to rule out every possible explanation for a slightly abnormal result? The answer is basically endless. Without a clinical question, the numbers don’t mean anything. That’s why medicine relies on targeted testing guided by a proper history, not scattergun investigations.
Random testing without a clinical reason just adds more stress to the NHS and it makes services even more difficult to access.
aenyeweddienn@reddit
It's not just a culture clash, it's a medico-legal issue. If you were a doctor, would you feel comfortable prescribing or treating a patient based on a diagnosis from a private provider that may or may not be correct? Would you trust it blindly and take on the responsibility and potential legal liability? Moreover, NHS is not funded to subsidise private healthcare.
ToughImprovement276@reddit (OP)
I probably wouldn’t just take a patient’s word for it or a relatively vague clinical letter, I really understand that. But in the case of my small blood cell issue, I’ve given the private lab reports to my GP and blood tests I’ve had done on the NHS over the years actually show the same thing. At that point, why not investigate the issue?
In terms of your point on not subsidise private healthcare, where do you draw the line out of curiosity? Given the issue with access to healthcare and timeliness with the NHS, surely by doing what you can privately and using the NHS as a backstop is cheaper for the NHS and uses less resources?
And I guess there’s a point to be made about people using private healthcare also paying tax towards the NHS, in addition to IPT if they use health insurance or VAT if they pay out of pocket. So on what basis should they have access reduced?
aenyeweddienn@reddit
It all comes back to the legal implications and the fact that NHS doctors have to follow strict guidelines.
As an example, let's say your private provider recommends tests X, Y and Z based on the results of test A. If you have test A under the NHS, the results might justify a referral for further test X, but not for tests Y and Z until test X is completed and results suggest you need test Y or Z. Referrals for further tests/treatment have specific criteria and if your case does not meet them under the guidelines, even if your GP ignores the rules and refers you, the referrals will get rejected. Private providers are not bound by any of that and can recommend all sorts of expensive tests and may or may not be needed right. Why would NHS pay for tests X, Y and Z if test X could potentially confirm you don't even need tests Y and Z? It would likely be more expensive and wasting resources and appointments by doing all 3 in one go.
Patients going private don't have reduced access to NHS services, they've got the same right as everyone else to get assessed and treated. What they can't to is "skip the queue" by getting diagnosed/assessed privately, and then expecting to get NHS treatment or tests (unless there's some sort of shared care agreement with that specific private provider).
That's all on top of the legal responsibility they'd be taking on.
Big_Turnover7420@reddit
It’s not correct that private clinics do not have to follow guidelines and justifications to carry out procedures be it tests, scans or anything else. We are held to CQC guidelines for care provisions and must also follow NICE Guidelines. Private practitioners must also adhere to their licensing bodies rules. SOP’s and justifications for private xrays for example are very robust.
Direct_Instance_8655@reddit
I understand the legal complexity to this. But wouldn't it make sense to have a more nuanced system in place where people can get asessments/scans/diagnosis done privately in, e.g. recognised private facilities, and these would then be honoured by the NHS? That would ease the financial burden on the NHS?
deimantek@reddit
this sort of does exist under ‘nhs right to choose’
MadApple_@reddit
For clarity, I’m a doctor.
Say you went privately for a consult, they did imaging. They found X which meant you needed surgery. You go to the NHS, you say I’ve had X imaging done and here’s my letter saying I need X. We would have to review your imaging, not just the result. So we would ask for a copy of the actual images. We would have to discuss the case with the wider team (eg radiologists or other specialists if required). If we need better imaging it would be repeated again. A lot of the times when patients aren’t able to get a copy, we just have to repeat the scan.
I feel quite a few people who have commented don’t actually know how the system works.
Direct_Instance_8655@reddit
Thanks for clarifying that. I can understand the need for reviewing the actual imaging, makes complete sense. But from all I've experienced and heard, I think often there's also just a blanket 'we can't use your private imaging at all' policy, which just seems such a waste of time and resources all round.
ToughImprovement276@reddit (OP)
And when you factor in that some private health providers actually run the private facilities at some NHS hospitals, it makes even less sense to disregard these.
I like your idea of having recognised facilities, especially as it gives patients an indicator of quality too.
MadApple_@reddit
Huh? For patients who have gone private, we usually have to go through more or less the whole process again. So for example, if you had a blood test privately, we’ll have to repeat that. Unless it’s a consultant referring a patient they’ve seen privately to the same hospital they work at in the NHS for a procedure, they get added onto a list of patients waiting for a similar procedure/for a bed.
Even in the NHS, with in house referrals, we usually repeat things again (ie why when patients see a few doctors, they’re asked to repeat the entire reason why they’re in hospital/clinic all over again).
ACanWontAttitude@reddit
Not a doctor I'm an RN; some of the blood tests they want us to look deeper into are borderline normal and can self correct in a week.
On another note, I am so shocked at some of the patients who have had private surgery and then had to come to us because of complications. Obviously I only see the bad things because of the nature of the work, but its shocking things, and also some super basic things that I think the private sector has no right operating on people on if they cant/arent willing to deal with after. I did respect one private surgeon who came in and visited his patient on our ward, engaged with us staff telling us as much as he could, listening to us (obviously all with patient consent) and it was a real joint effort to get this patient better. I have never seen that before from the private sector.
Some of the NHS surgeons i work with do private surgery lists which i think is fine, if you can do it why not earn extra money. Although one got his patient onto my ward and the patient was trying to demand a private room, other privileges etc. I shut all that down quickly!
sqnch@reddit
The NHS doesnt care about anything proactive or preventative in my experiences. They just want to tick a box and get you out the door.
RainyDayBrightNight@reddit
As far as I know, the only difference between private and NHS is that going private is like paying to skip the queue, and that going for private allows you more ability to choose who you want to see.
With the NHS, you have to wait longer and you’ll get allocated a doctor who may or may not be good at their job. If they’re rubbish, it’s a bit of an effort to get switched to a different doctor.
The NHS is fantastic for most everyday and immediate stuff. Private is good for unusual and chronic issues, where you might need obscure specialist help and would have to potentially wait for years to be seen by them on the NHS.
The NHS has been fantastic for my own issues and my families’ issues; appendicitis, broken bones, iron deficiency, cancer, etc etc etc. However, I did have to go private to get my diagnosis of FND, because it’s extremely obscure and wasn’t a direct danger to me, just decreased my quality of life, so understandably wasn’t a priority for the NHS.
deimantek@reddit
i’ve not seen my GP face to face since before covid but he did sign my shared care agreement for adhd after some grumbling. but not before the practice claimed to have not received the psychiatrist’s multiple emails and letters with my diagnosis - this was via nhs right to choose so not even fully private 🤷♀️
Puzzled-Mycologist61@reddit
Most private doctors have an NHS practice too.
mmmmmmmmmmmmu@reddit
Makes absolutely no odds and it's actually beneficial in some ways as the person has paid for the process of diagnosis. To be honest if you can afford to do it that way it's actually a help to the NHS
Ben750@reddit
I used to have private medical through work. When getting a referral from my GP AUTHORISED, the private company suggested the private doctor should refer me back to my NHS GP for any blood tests etc. so I didn't use up my outpatient allowance. When I raise this with the Doctor he told me not to worry about it, once my private allowance was spent he'd refer me to himself in the NHS for further treatment.
Agile_Media_1652@reddit
Frankly, GPs in the UK are a fucking joke now.
All they care about is covering their backs against possible legal action (another appalling hangover from the US that's got here) which is why they try to avoid diagnosis and treatment wherever they can.
And saving money which is why they are refusing to put people who need it on meds.
And on top of that, they absolutely hate patients and rip them to pieces in the others sub reddits.
I've seen some disgusting behaviour in them including doctors actually discouraging people from attending A & E without knowing that persons history, medical background or current status.
They will also tell any patient that asks for help / information that they need mental health treatment which is simply shocking and pathetic.
I always ask the question doctors, if you hate the job, and the patients so much then why do the bloody job?
You don't need to be martyrs to the cause, we don't give a fuck. Just leave and find another well paid job and stop bitching about how crap your job is and how little you get paid.
Agile_Media_1652@reddit
The impression I get as a patient is that they fucking hate it and will do everything in their power to be as difficult as possible about any ongoing treatment.
I would like to say to them that it costs the NHS less doing it this way so the patient is in fact reducing the burden on the NHS but I don't believe that's the problem for them.
They simply dislike what they view as "queue jumping".
No, it's just people scraping together every last penny to try and get their life back.
ippwned@reddit
Doctor here - hard to be disdainful when I would do the same myself.
coderqi@reddit
It's NHS doctors treating them privately. And making bank off it.
jrw1982@reddit
After many failed diagnosis attempts for my condition I went private (have pmi with work) after eventually getting a referral. Within a month I had had multiple appts, a colonoscopy and a CT colonography (which was done on nhs as private didn't have a CT scanner for that). I was then referred back to NHS for urgent surgery which I had within 3 weeks of the referral back.
No issue at all.
Individual_Meal_728@reddit
I’ve got ME and colitis. Same for me. GP dismissed tests for literally years because they were in ‘normal’ range eg ferritin of 11, which frankly isn’t functional at all.
Private docs immediately saw need to investigate further in both obvious and related areas - which found the cause. Honestly I am traumatised by GPs who have ignored me for years when they were the people I trusted. They are overwhelmed and under trained in my opinion which is dangerous to anyone with anything slightly rare. You need a private doc who can spend money for that. Awful for those without private healthcare 😢
jrw1982@reddit
I have the same now with migraines.
Luckily ive latched onto a GP at my surgery who actually seems to care. Shes only seen me once though and everything else is over phone.....which is an ordeal in itself to get booked and usually takes 6 weeks for an appointment. This has been going on for over a year now.
On my 3rd lot of different prophylactic though and still getting them so next step is a neuro referral and ill go private and pay the increased £250 excess (was £100 prior to renewal at start of the month) and hopefully get these injections on prescription through NHS which i forget the name of at the moment and are apparently very good. Im currently burning through anything up to 12 sumatriptan nasal sprays per month to be able to function normally.
Another bonus is this last lot of tablets are also for blood pressure which is now spot on!
Jager720@reddit
I've just had a similar thing - having GI issues and have been in on the waiting list for an endoscopy for a few months.
Paid for a private Gastroenterologist appointment, and he asked me GP to refer me to his NHS clinic.
Within a week of that referral, I've have a full body CT and blood tests done on the NHS and have the endoscopy booked in in 2 weeks time.
GGGJabs@reddit
The waiting time to see a sleep specialist/consultant where I live is 228 weeks (not a typo) so I felt like I had to go private and come back to the NHS with the results.
ToughImprovement276@reddit (OP)
Omg??? That’s actually crazy.
StandardHuckleberry0@reddit
That's also about average wait length for NHS gender clinics for a first assessment for gender dysphoria. The shortest is like 2 years, most are 4+, and the longest (Glasgow) is basically undeterminable, some calculations based on the recent extremely low rate they see patients say it's 200 years (not a typo!!) lmao.
ToughImprovement276@reddit (OP)
Wtffff
Tbf I used to work with someone who used to buy testosterone online to aid in their transition because waiting times for the gender clinic were really long. I thought maybe 18months or so, I didn’t realise 2 years was the lower bound!
Important-Double6821@reddit
Just to add to this, I've been on the waiting list around 7-8 years and still haven't heard back at all lol, no idea when they'll get back to me
StandardHuckleberry0@reddit
Yep, pretty common. There was a post recently on the uk trans subreddit from someone who was referred to the youth gender clinic at age 12, 7.5 year wait, didn't get seen until age 20.
ToughImprovement276@reddit (OP)
Fucking hell and from what I’ve seen in the news they’re only reducing access. I can’t imagine how difficult that is to manage mentally, especially if you can’t afford the hormones.
Liv_October@reddit
My friend went private for her trans healthcare and has worked out by the time she's at the top of the waitlist for the NHS, the only thing left to ask about about will be continuing her existing hormone treatments. They're going to be assessing if she has gender dysphoria and they'll be looking at someone who for years has legally transitioned, medically transitioned, socially transitioned... Feels a bit ridiculous.
GGGJabs@reddit
It's unbelievable. I am not rich and the private diagnosis has really set me back financially.
concernedBrit882@reddit
How was your experience of going back to the NHS with the private diagnostics? Did they accept the results or make you do the tests again?
GGGJabs@reddit
I haven't spoken to my GP yet as I only sent the report yesterday. They can't really argue with the results so hopefully I can get treated soon.
marktuk@reddit
My partner just did that recently. NHS wait was insane. We went private, and had a diagnosis in under 2 weeks. Now we're back on the NHS waiting list for a CPAP machine. Half of the time with the NHS so far has been communication failures between the various departments that we've had to keep chasing up. The referral didn't actually happen for 6 weeks because the receptionist at the GP didn't do it. They only did it after we chased it up.
Snooker1471@reddit
My adult niece has Addison's disease as well as other conditions which make her everyday living pretty poor. Addisons as far as i understand it is her body does not produce cortisol that we all produce naturally so she has to take it herself by inj. the problem is the inj can make her overloaded with the cortisol and before it's time to take the next inj she can become dangerously low on the cortisol. The "answer" was private doctor who has adapted an insulin pump to deliver the cortisol at precisely timed intervals and amounts which can be adjusted as time goes on while monitoring the patient's health and reactions.
It cost her £6k. It has saved the NHS thousands since she no longer has to attend hospital several times per year for Addisons crises which can be life threatening and is always an emergency - think of the costs of each emergency and then 5+ day in hospital.
Do you know the NHS won't even pay for her tubing that needs renewing all the time, They won't pay for ANY consumables they most certainly won't pay for a new pump when this one is due to be replaced.
IF she had diabetes this would all be free - same thing but delivering a different drug - insulin. They have also found that she may need a stent in her arteries - but they want her to go private as they are not comfortable treating her while she has this infusion pump fitted.
It is absolutely ridiculous. She is not rich, she fundraised the cash for the initial pump. She actually works and pays tax and NI. One would say that if she was living in the USA and had private medical insurance then that insurance would pay for it all (this has been confirmed by American Addison's sufferers who have had ALL their treatment paid for by their insurance. She is healthier than before the pump, and having the pump might just enable her to live to a normal age. Every "crisis" is potentially the last one. She has a young family too. it really is shocking.
positivelittlecorner@reddit
Really happy for her that she’s doing so well and life has improved with the pump. Addisons is an awful and often terrifying condition.
Unfortunately, not all insurance is the same in USA and things that are covered one year are not covered to the next and this can stick people with ££££££ of medical debt. There is a very good reason that there is uproar about medical insurance in the USA. Just because one person has their care covered for this condition and care, does not unfortunately make this the case for all.
Snooker1471@reddit
Yes i do get that the USA has extensive problems with their insurance based system. What I was trying to get at was the fact that the UK in all it's "Free at the point of use" system will not provide the care that is already approved in other countries, has been proven to work and is actually available in this country by going private. She is/has been paying for her "insurance" through her tax. It's not free but currently she is getting nothing in return. Even a sniffy refusal to give her treatment for a separate condition unless her private doctor is present - Advising her that she would probably be best if she just gets her private doctor to do the stent for the blocked artery.
Maybe more accurate if I had stated that if she lived in most of the EU and surrounding countries with their insurance backed state care systems then she would not be in this situation. I can understand if this was outrageously expensive treatment, Or it just hadn't made it to the NHS yet, But in the grand scheme of things it is not that expensive. It IS expensive for an individual person to afford themselves while still paying "into the pot" for others to receive the same equipment as long as they have a different disease.
She is in Scotland, And this London clinic did say if she moved to within their catchment area then the doctor could get all her stuff apart from the actual pump done through the NHS as it's funded in his region and he would be able to set up a co-care arrangement as he also works for the NHS.
She even has to go to a private clinic in Scotland for the "routine" blood tests for her condition as the NHS will not do them while she is still receiving care for the London clinic. To be perfectly honest I actually think this is an MP/MSP issue as she seems to have fallen through a crack somewhere along the lines.
positivelittlecorner@reddit
This seems absolutely wild that this hasn’t been approved as it seems to work so well and addisonian crises and addisons mismanagement in itself can be so costly to the NHS. I would be very interested to know what’s the QALY or ICER for this treatment is (or whatever calculation they use for medical device equivalent). Is this something that other people with addisons have been raising with the NHS? I’m in the NHS in wales so don’t know much about how the NHS funding works in Scotland as we are devolved for healthcare here. It must be awful to know this device is available and works but not be able to secure the funding.
I do think (and understand why) a lot of people feel they don’t get their moneys worth from the NHS, but most people won’t as most get the bulk of their care in older age. The amount that most low and middle income earners pay towards nhs health care is generally less then they will utilise in healthcare costs, but people diagnosed with complex medical conditions at a young age will generally receive more healthcare in terms of cost than they pay in over their life. Things like palliative care can total up to £35,000 so the costs in later life certainly add up. A fairly basic 5 nights in a hospital with a chest infection needing iv antibiotics and oxygen can total over £9000 and that’s not uncommon for older people. I imagine most people feel the same frustration though about feeling that they don’t get what they pay in.
I always feel very torn as an NHS staff member and a lefty but as someone who is a patient and have loved ones who are patients, I can see all the failures and inadequacies as well. Many European systems seem to have us beat but sadly our politicians seem set on having us either in a USA based system or a crumbling NHS. I don’t know how much longer things will limp on with the NHS is such a sorry state.
It does sound like it’s worth your niece getting in touch with her MP or reaching out to Addison’s charity’s for further advice. It seems like a genuinely life changing device. I hope they approve it for her.
Soggy-Attempt@reddit
Why wouldn’t you the system this way?
GreenandWarm@reddit
NHS hospital doctor here.
This is an interesting question and the answer depends on a few things.
Firstly, I have no issue with people going privately and it does get things done faster. I wish I could tell patients “you can go private if you want a quicker appointment” but it’s not considered very politically correct. However if patients ask me, I will check with my boss who to put them in contact with and that’s usually fine.
There are two types of people that go private. Ones that genuinely just want a faster appointment, and ones that think going private is somehow better. The fact is that private consultants are the exact same people who work in the NHS. The one benefit is the speed and the fact that they get longer appointments. Everything else is the same.
The people that bother me are the ones that tell me they’ve gone private then get annoyed that I don’t have their results. The fact is that systems do not communicate and unless you physically bring something with you to the appointment, I don’t have a clue what you’ve had done.
As an extension to this, if you’ve been seen privately repeatedly, then end up admitted to an NHS hospital because you’re sick, we won’t have any record of you and that delays care.
Finally, something to add is that if something goes wrong and you get sick perioperatively in a private hospital, you will end up being transferred to an NHS one.
I would go private for some things but not for others. For the most part I would want all my care done in the NHS.
LB2024_@reddit
Patients don’t understand that they will still have a very long wait once referred on the NHS pathway to secondary care - just because they’ve had a private investigation done it doesn’t mean they can skip the outpatient queue. I administer referrals at a large GP practice in West Sussex. It’s so frustrating when a private consultant says to the patient “I’ll see you in my NHS clinic” as the patient’s insurance doesn’t cover further investigations/treatment or the patient was self-paying for a one-off test or consultation. The patient then is under the impression they’re not having to start from scratch but they are.
Illustrious-Air-7777@reddit
Our surgery has a screen with information on it saying that if you have treatment outside the NHS you’re on your own.
Easy-Equal@reddit
How does that work for people who get hurt or has an injury outside the UK does your surgery just abandon them? Sounds like it goes against their duty of care and British Medical Association guidelines
GL510EX@reddit
It doesn't work because it's not true, certainly not the way they summarised it.
Illustrious-Air-7777@reddit
I don’t have the wording to hand but I assure you that’s the gist.
GL510EX@reddit
I'm not saying you're lying, but if they have worded it that broadly, it's not true.
Illustrious-Air-7777@reddit
No idea, I haven’t tested it other than going to a private physio because the one assigned by the practice attempted to give exercises for an injury that is somewhat out of the ordinary via a voice call.
CandidLiterature@reddit
I mean ultimately if you do have a medical condition, they just need to deal with it same as they would if someone else had it… If it’s something that needs specialist oversight, that might mean a repeat referral but they can’t just ignore you. Unless it’s something the NHS don’t treat for whatever reason.
WISJG@reddit
Exactly what medical care are you denying people?
If someone is on the waiting list for something for over a year, uses their hard earned savings to pay and suffers a post operative complication which could occur on the NHS as well as privately - you refuse to treat them?
Illustrious-Air-7777@reddit
I’m not denying anyone anything. I’m a patient there.
sleepyprojectionist@reddit
In the last five years I have been registered at two different GP surgeries.
At neither surgery have I actually met my GP.
I have had the occasional phone appointment or I have been sent to see a nurse practitioner or a healthcare assistant.
I spent years complaining about chronic pain and my doctor took no interest. All they did was send me to an NHS physio who told me that it was all in my head.
It wasn’t until I went private through my insurance from work that I received a diagnosis for seronegative rheumatoid arthritis.
I had to be referred back to the NHS for medication.
My GP surgery somehow misplaced that referral twice.
By the time I did get a referral to an NHS consultant rheumatologist it turned out to be a doctor in his late seventies who couldn’t use a computer and had to have a nurse with him at all times to take notes and catch any mistakes.
This particular doctor made a real stink about me getting diagnosed privately and wanted to run all of the test again despite me providing him with results from MRIs, X-rays, blood tests, and tests of synovial fluid.
Even the nurse in there thought this was unreasonable and had me transferred to a different consultant.
I am now on my third medication after the first two caused horrendous side effects.
Every time a request goes through to my GP for changing prescriptions for supporting medications or requesting vaccinations, they get conveniently lost for a month.
It took less than six weeks for me to get multiple scans and tests, a diagnosis, and a suggested treatment plan from BUPA. In comparison the NHS is an underfunded bureaucratic nightmare.
I honestly don’t care what my NHS doctors think. If I had stuck with them then there’s a chance that I would still be in pain, but have no one believe me.
sisterlyparrot@reddit
i’ve had very similar experiences to you with a different rare condition (urticarial vasculitis). nhs doctors like to think they’re always in the right and the NICE guidelines are always right and that patients seeking private healthcare just don’t want to hear what they have to say. unfortunately a lot of the time they just don’t want to listen to what we have to say, in case they have to admit they don’t know something. in my experience, as soon as you have something incurable, they don’t give a shit.
milrose404@reddit
I have a lot of autoimmune issues and completely agree that the NHS is a bureaucratic mess. I even had blood cancer when I was 18 and that was impossible to diagnose for almost a year for the same reasons. You are literally run ragged trying to access any sort of consistent care for complex or chronic conditions. It’s exhausting. I’ve gone private a handful of times and always been immediately listened to and provided tests and treatment, which ultimately led to correct diagnostics.
I’m seronegative too!
sleepyprojectionist@reddit
My current NHS rheumatology nurse is fantastic.
She checks in on me every 4-6 weeks, listens to me, makes recommendations and sends all of the required referrals to my GP.
It was getting past the disinterested consultant that was the real test.
I have essentially given up going to my GP for most stuff now though. The surgery is stupidly oversubscribed and the staff, whilst seeming lovely, appear to be struggling.
MercatorLondon@reddit
Lot of these NHS doctors work for these private health care companies as a consultants.
MrJones-@reddit
A lot dr’s deal with you private then once it comes to long term treatment they switch you over to themselves as a NHS patient.
Booleanpuzzlehead@reddit
Do a bunch of people with open contempt for their patients and colleagues have maybe 2% more contempt for you if you seek help? I'm not sure it matters l, especially because they then know that if they fuck it up, you'll go back to someone who can prove it.
stealthw0lf@reddit
GP here. In general, I don’t care or mind. Sometimes I encourage it. Example: local wait time for neurology is two years. If I suspect Parkinson’s disease in someone, I’ll tell them to go see a neurologist privately and to see someone who works at a local NHS trust. That way, they get a timely diagnosis and then medication (which has to be initiated and overseen by a neurologist) can be commenced.
Sometimes private consultants do weird and crap things eg patient sees a neurologist. Neurologist recommends MRI scan. Patient can’t afford it. Neurologist asks GP to arrange scan. Except we can’t do MRI scans. I have to write to an NHS neurologist to ask for their permission to do an MRI scan (and attach their approval to the referral). Private neurologist knows this because it’s policy in their trust. They could have just arranged the scan themselves via the NHS instead of getting GP to do the work. Ditto with consultants who want patients to undergo a battery of blood tests and ask GP to do them - some of which we can’t do, or request or are inappropriate. Sometimes I have to refer the patient to the same consultant on the NHS just so the investigations can be done - IMO a waste of my time when the consultant can do it themselves.
Then there are the dodgy consultants who do things inappropriately or start operating outside of their expertise or do things that they should know better.
Having said all that, if the NHS was very well funded, staffed and equipped, it would be able to do what the private sector does in the same manner. Hell, in the early ‘10s, I used to get people to go via the NHS as they’d often get seen as quickly, and get the same expertise in a timely manner, without needing to resort to using private insurance.
hundredsandthousand@reddit
I think one of the most embarrassing moments of my teenage years was when a locum GP told me he wanted a stool sample. Brought it in and told the receptionist who looked at me like I was nuts but accepted it only to get a phone call later telling me they don't do those.
So I basically just handed them a pot of my shit that they had no clue why I'd give it to them lol
ToughImprovement276@reddit (OP)
This is so interesting to know what happens behind the scenes. But yeah that’s a piss take it seems like some private consultants are using you as a glorified PA. Is there any benefit to them by pushing these things through a GP instead of following the proper channels or just pure laziness?
The NHS of the early 2000s and 10s was glorious haha. I have a genetic condition which I’ve been treated for since a child, and has triggered a bunch of other conditions in adulthood, but I remember things being so much more efficient and comprehensive back then.
ZealousidealSky4851@reddit
Depends - I can see both sides of the argument.
If you had an issue that would be seen to on the NHS but the waiting lists mean private may be better E.g private Knee/Hip or the NHS won’t cover due to costs (Cosmetic work) - I sympathise and I encourage my patients to seek help in the private sector where the NHS may not be up to scratch.
What really grinds my gears are the companies that market health checks but then test for a million irrelevant bio markers then wash their hands of responsibility and dump the work on you.
Just come to me in the first instance lol, tell me your concerns and we’ll see what we can do.
Ok-Measurement-1575@reddit
The only disdain is from those not yet on the gravy train.
ChaiTeaAndBoundaries@reddit
The person who orders the test should be responsible for its management. Many private facilities charge people for these tests and then send them back to the NHS for management, which is wrong.
becpuss@reddit
I think there’s a huge misconception about private health insurance. Many people think you get better healthcare when it’s the same Doctors and nurses that work for the NHS making extra money going private for some hours. It’s not better. The food is better. Maybe the sheets are better, but if you have an emergency in private Surgery, you’re going to an NHS hospital my sister is an NHS doctor she doesn’t mind if people go private if you need to jump the queue and can afford to do so fair enough no judgement
though she is an A&E consultant and trauma specialist there aren’t very many private A&E emergency rooms. So there’s no working privately for her not that I think she ever would work privately she believes in the NHS .
One_Feeling_8734@reddit
It depends: if it’s private work to essentially skip the waiting list then I’m all for it, it takes pressure off the system and means the queue is shorter for everyone else. The thing that gets my goat is when patients fly to turkey for a cosmetic procedure, get butchered, and then we have to pick up the pieces. Both happen frequently where I work.
im-sorry-watt@reddit
The NHS needs to be brought down several pegs. Can't fix a system which thinks it's Gods gift to the world
ManBearHybrid@reddit
I was recently diagnosed with thalassemia beta trait, and I can tell you that my NHS doctor similarly tried to brush off my concerns. This is even though he was my only doctor. Despite my family history, weird FBC results, and constant fatigue, my doctor was hesitant to even order the test. His opinion was that that having a diagnosis doesn't really make much difference because it's allegedly symptomless.
I really had to advocate for myself here, making the argument that it's also important to know about yourself because blood tests can look like anaemia (as you've found) even though you're actually in iron overload. Thus it can be dangerous to take the iron supplements that are commonly prescribed for people with anaemia.
The outmoded perception is that people with thalassemia trait are "silent carriers", i.e. that it's pretty much symptomless, so this is why I think older doctors especially think of it as a non-issue. But newer studies show this not to be true.
ToughImprovement276@reddit (OP)
My GP said more or less the same thing as your actually, so I just left it. Although I found out soon after that my partner has a thalassemia trait and we’re undecided on whether or not we’ll have children, so I’ve been thinking about trying to start that crusade again but may just save and pay out of pocket for peace of mind.
Interesting to know that it’s not entirely symptomless. I have another chronic condition that makes me fatigued and gives brain fog, so it would be hard to determine how much is caused by either - that’s if I do have that trait.
ManBearHybrid@reddit
I think it's worth going back to your NHS practice and tell them that you're considering children and your partner is positive. That really does change things in a fundamental way. It's a very valid concern to want to avoid having a child with thalassemia major.
It annoys me that we have to fight like this. You're entitled to this treatment. You pay taxes for it. Don't let them off the hook.
marmiteyogurt@reddit
My GP seems to hate with a passion anything to do with private work, the only reason I've gone private is failings on his part, so I don't really care what he thinks about me going private.
I went private for cancer diagnosis and then treatment and a less drastic gallbladder removal due to misdiagnosis and struggling to get past my gp to a specialist type thing. My surgeon after one of my surgeries (which was miles away from home) asked my gp surgery, if anyone there could remove the stitches to save me several hour round trip, and the answer was no with a fairly sneery we don't do private work (which baffled the surgeon and he complained more about it than me) I'd get if I was getting a BBL or something, but these were all essential things, that the NHS ended up not having to pay for.
positivelittlecorner@reddit
I mean, stitch removal is something that is directly related to the surgery that you had and if there were issues with the wound, this should be managed by the private company and should be part of your post op care.
I think in this situation, it’s very fair and reasonable for the GP to have declined this particular request.
marmiteyogurt@reddit
If the GP had treated me correctly in the first place his practice would have been removing stitches anyway as I’d have had my cancer treatment on the NHS. He was being asked to remove stitches so I didn’t have to travel back hours for a simple stitch removal after a fairly rough surgery and reconstruction.
Popular_Ice1651@reddit
I think it's when people in a private setting do tests that they don't understand, or occasionally do understand but just don't take ownership of, and then because of one or both of those two things, they ping it across to the GP/whoever, often accompanied by unrealistic information about what may need to be done next, generating a lot of unnecessary work trying to clear up the mess. In short people offer tests that they don't know how to correctly interpret, without a clear reason for sending them, which then also makes interpreting the result less than straight forward, and hand that on.
Particularly where companies are raking in large amounts of £££ for doing tests regardless of if they have a good rationale for them or not, but taking zero responsibility for having to deal with any of the results, including generating tonnes of unnecessary health anxiety about results which are in fact irrelevant. And then effectively using your GP as an unpaid stooge to interpret all of it for them.
For example recommending thalassaemia testing to you (if that's how it was phrased). Checking your iron levels isn't the craziest thing in the world (although if your Hb is completely normal and you have no symptoms, probably v unlikely to have any significant iron deficiency) - but the only reason to test for thalassaemia trait outside of academic curiosity would be if you had kids with another person who had a haemoglobinopathy where there was potential for a problem in the kid. Which would always be picked up at the pregnancy booking appointment. Whereas now your GP needs to spend a load of time explaining that to you OR they may just roll over and test you for it - even though it will have zero impact on anything in your life other than potentially generate some unnecessary health anxiety, if you are an anxious sort of person. To be fair given the fact it's not totally crazy to check your iron levels for thoroughness, this one isn't a massively egregious example, but I guess I'm just using it to explain how some of this stuff and what is said about it can generate a lot of work and unrealistic expectations.
Obviously lots of legit private blood tests/practice is on the other end of the spectrum and really helpful to get care faster and alleviate pressure on the NHS etc etc. Like your thyroid results!
I don't think any of the above is the fault of patients at all btw, it's to do with people/companies offering stuff they are not equipped to deal with the ramifications of, and then passing the buck on it.
Far-Presentation6307@reddit
They seriously frustrate me. Luckily in my field they normally only come back if they have cancer, but occasionally come back with complications of private surgery or have a half-completed workup for something and many of the decisions made to date were not conventional ones.
I can only imagine the frustrations GPs have from people getting blood tests done privately.
If a private doctor is ordering tests they should be responsible for dealing with the results, not dumping them on your GP and washing their hands of responsibility. If the private endocrinologist thinks you need testing for anaemia or thalassemia trait they should go ahead and organise it.
ToughImprovement276@reddit (OP)
The private doctor was happy to look into it but my health insurance wouldn’t pay for it as they don’t cover diagnostics for screening purposes. So they told me to discuss with my GP who has since told me that it’s not serious enough to investigate.
Turns out that my partner has a thalassemia trait, so I may end up paying out of pocket to get that checked out if we do plan on having kids.
cwtchyfemme@reddit
Pretty normal here. The doctors I’ve seen privately I’ve also seen in our local hospital afterwards.
KeyJunket1175@reddit
Yeah I don't bother with GPs in the UK. So I guess I am doing something good by reducing the strain also. Wherever I lived around England I never got to see an actual doctor or get anything done. Luckily I am still eligible for Hungarian public healthcare so I just go back to do my routine extensive blood tests for free every year, at the same time I get my teeth checked and done in a private dentists back home for 100 euros. Same thing for melanoma screening, I can get it done at a public hospital if I wait a bit, or pay a 100 for private. I have heard NHS is a postcode lottery, seems like I never get the right numbers.
ReinforcedTube@reddit
See, this is why people think private is "better" because being offered more tests is "better" when there is incontrovertible evidence that this is not the case. Random screening outwith validated programmes is more likely to cause harm than not. The risk is not missing disease. The risk is from invasive investigations and treatment when the disease was not actually present.
Great-Big-3101@reddit
This British mentality of thinking you never need preventative care is madness.
Messka85@reddit
Moaning that the NHS is underfunded and at the same time refusing to do preventative care which would save no end of money. Makes sense doesn't it
Canipaywithclaps@reddit
There is a middle ground here.
I’m an NHS doctor but I have a number of things I’d like to get checked which I can’t access under the NHS, for example:
- skin checks (I have lots of moles and prior to understanding the risk was burnt many times, it’s a ticking time bomb that the NHS will probably miss)
- MSK ailment, not disabling now but causes niggles, I won’t be eligible for NHS care until it becomes disabling.
- familial hypercholesteolaemia runs in the family, GP won’t check more than once every 5 years (even getting the check took me having enough medical knowledge to justify it).
- blood clots run in the family due to an inherited clotting disorder, I’m female of childbearing age… Ive avoided certain birth controls (despite the GP trying to push them) but I’d like to know if I have the condition to make more inform contraceptive choices (am I avoiding them for no reason?) and it would have consequences in pregnancy.
- I have a condition that impacts fertility alongside a job that screws up fertility, in the ideal world id have some basic tests done to know how short of a clock I have
muffledsnaps@reddit
Why does being a doctor screw up your fertility? 😨 from radiation?
Canipaywithclaps@reddit
High stress + unstable shift pattern + nights + more work hours per week than average = really screwed up hormones
KeyJunket1175@reddit
Annual bloodwork, teeth, melanoma and perhaps not annual but routine breast cancer and testicular cancer screening is pretty basic. Sure, I don't expect to have a head CT and MRI randomly every year, to make sure I don't have brain tumor. During the 6 years in the NHS I was only called in for a BP check once, even though I used to have high BP and used to take medication, and it's on my NHS file. I only found out about it to begin with because it was high during a random screening and I was given a 24h monitor. Mind you, this is Hungary, not some magical welfare state.
dmada88@reddit
There’s something here about British queue culture. Going private for a diagnosis and then back to NHS for free treatment smacks of jumping the queue. From the patient perspective of course we want our problem dealt with. The doctor may privately fume about their other patient who is suspected to have the same condition but is still waiting in the queue for a consultant to investigate or authorise tests.
pumpkinjooce@reddit
Not a doctor, nurse, but I work in a clinic with a consultant. We have a LOT of patients that go private for testing then come to the NHS for treatment, they all seem quite irritated that the wait list for NHS treatment is still the same as if they hadn't gone private for testing. It doesn't bother us at all, it does seem to bother them though.
And to be fair, sometimes getting any form of clinical correspondence from the private sector is difficult as we don't often share the same systems and therefore have to write to request information which can delay referrals to other NHS teams or delay putting the patient on a wait list for treatment. Top marks to the patients who bring in past correspondence with different teams with them to clinic, gives us a much clearer picture.
positivelittlecorner@reddit
From a kidney stone point of view, the wait for surgery is insane (unless it’s emergency surgery obviously) and the pain from stones and stents can be really debilitating. I have a small number of my patients who will be diagnosed in A&E, have follow up with NHS and then opt to go privately for surgery. I give the mm the info they need and the letter recommending surgery. Their surgeon then writes to me to tell me what’s been done and I generally pick up with the follow up as I would have done if they had NHS surgery. Their private surgery has just given an NHS patient a quicker operation so I’m not about to act like a prick to this patient.
This being said, if their private surgeon recommends a test or investigation that we don’t usually do in the NHS, it’s not getting done without good reason. We have budgets to try and give good care to everyone, not to spend money that we don’t have on a ‘nice to have’ for one person. Usually, the reason we don’t offer certain tests or investigations is because there’s not enough evidence to show its benefit or there are similar tests/ investigations/ procedures that give similar results but for cheaper and the other test won’t change the way we manage your condition.
Also worth mentioning that I hate that people accessing private care is some ‘favour’ to people who need to use the NHS and if patients have this kind of attitude when they are telling me they are going private- I will think you’re a class A twat (but I will not let that show and I will still help with the private referral). Working class people don’t need people with PMI to do them a favour by going private, instead people with PMI should recognise with within the current political and economic climate and with the NHS being underfunded and terribly run, they are really very fortunate and nothing else.
lollybaby0811@reddit
I had gastric sleeve in Turkey.
Sometimes doctors will give the standard aftercare, mine said no lol. I have paid taxes for a long time and needed a b12 injection, quarterly. Anyway I ordered from Germany and used to shoot up easy.
They hate it. Their line for service is long a.f and dont care to help who help themselves
MadApple_@reddit
As an NHS doctor, I don’t give it a second thought. A lot of my consultants work privately as well, so most people are just seeing the same doctor they’d see in the NHS. We also have patients that come from abroad for treatment and I also don’t give it much thought. I’m not sure why any doctor would care really, people are free to do and choose whatever they want.
spartacle@reddit
I’ve had no issue but for my issues I had regular checkup, physio, plans etc on the NHS but surgeries were private but my consultant was the same both in NHS and private so it was continuous support from him
Prize-Corgi-8692@reddit
We honestly don’t mind if you go private and have appropriate follow up and post op care, however when you go private over sea and have a botched job and then get short with the gp who is trying to work out what you had done what went wrong and what needs doing and how to arrange it and demand it all to happen instantly, that can be a touch galling
swansw9@reddit
I’m an NHS doctor in a specialty where quite a lot of my patients will get random investigations and then bring them to me to deal with. Sometimes it’s fine, and gives me useful information, but often times it’s a bit frustrating for various reasons.
Sometimes private clinics send random tests for no reason at all. We have a maxim in medicine which is ‘treat the patient, not the number’. This means we should only investigate abnormal symptoms of illness. The private sector often send unrelated blood tests or just do random scans on the worried well. We all have variations in our anatomy and physiology so these unnecessary tests often show up ‘abnormalities’ in a completely well person. Well once we find an ‘abnormality’ it generates a huge amount of anxiety in the patient, and then can be a bit challenging to know how to manage. Should we really be doing an operation to remove an ‘abnormality’ which is causing no issue at all? What about the risks that come with that?
Secondly, we have another ‘rule’ in medicine which is that whoever orders the test, should act on the result. That way we select appropriate tests with a plan in mind - if the result is X, my plan is Y. It is considered unprofessional to order a test and then not review/act on/communicate the results, and unprofessional to expect a different colleague who doesn’t know the patient to do that step for you. So in my opinion if the private sector is going to do a test, it’s their responsibility to at the very least explain the result to you.
Finally, patients assume that the quality of healthcare and testing in the private sector is better than the NHS and this is often not true. I do a lot of ultrasound scanning and the quality of images and reports from private clinics is VERY variable. Some reports are not worth the piece of paper they are written on. If there is a discrepancy between the private scan and the NHS scan, patients usually assume the private one was ‘correct’ and it is frustrating when I can very honestly tell you my scan was better quality. In a separate note, NHS practice is required to be evidence-based, whereas private clinicians sometimes make some really rogue plans (the cynic in me suggests this might be to support their profit margin) - and again, people come to me expecting me to continue the very expensive and completely not appropriate/evidence-based medications their private doctor started.
There’s nothing wrong with going private and there’s nothing wrong with staying in the NHS, but hopping back and forth between the two is not straightforward and causes us a fair bit extra work in undoing odd decisions made by others that we never get to interact with.
ToughImprovement276@reddit (OP)
Thank you for such a detailed reply! It’s always so interesting seeing what happens behind the scenes with doctors and the NHS and tbh this is all very valid and understandable.
Whenever I go private I always use the same HCA hospital that seems to be highly regarded but I’m realising now that private doctor doesn’t always mean private hospital or proper medical clinic. It can also mean those dodgy wellness places on the high street too and as you can say quality varies massively.
To me, because a lot of the private doctors I see also work in the NHS I just assume they’re all the same in terms of quality but of course this won’t always be the case and I understand what you mean about not doing all the investigations for tests that you didn’t order.
Thanks again for this reply, it’s been very illuminating.
swansw9@reddit
You’re welcome! I didn’t intend for it to be so long but once I started I couldn’t stop!
Lots of my consultant colleagues do private work and absolutely practice in the same way whether an NHS or private patient - the private patient just gets more convenience, a nicer waiting room and guaranteed to see their preferred consultant. This is all well and good, and they can often then transition back into the NHS seamlessly. The challenge is more all the online blood testing, ‘wellness’ clinics, pop-up ultrasound shops.
swansw9@reddit
A caveat to this is I absolutely don’t judge people for going private, the NHS has many pitfalls of its own and I’ve considered going private for certain things before. I’m just trying to explain why it’s not always straightforward to bring me a private result and expect seamless transition of care!
Tiny_Parking@reddit
My Apple watch told me of suspected sleep apnoea symptoms. Get tested by the doctor and yes, I have central sleep apnoea. Not the same but the doctor accepted the results of the watch.
grotgirl@reddit
Went to the GP with some gynae issues. GP said it could be cancer, referred me to NHS gynaecology but because of covid there were long waits. I was fortunate enough to be able to pay for a private gynaecologist appointment where he decided i was suffering from vaginismus and likely had endometriosis, but would need an operation to confirm the endo. Went for a follow up with my NHS doctor and told her what the gynaecologist said. She immediately said, “no you haven’t got endometriosis.” And so that’s that i guess. Never did find out if it was cancer.
Fearless-1265@reddit
When I was having issues with my toenails I would get monthly private chiropodist appointments but when it got to the point that it looked like I would need to get the nails removed completely (and stopped from coming back) we went with the NHS as they could do it closer to home and were available sooner for the appointment. Had the added bonus of not being £300. I don't think the doctors / nurses really had an opinion of us switching as my nails were really bad and definitely needed treatment ASAP, plus I was 14 so that likely factored in as well.
ItAintNoUse@reddit
I may not be the best person to ask as I'm starting GEM in September, aiming to become an NHS GP.
That said, I don't think I personally would care too much. Anyone who is in the medical field will know first-hand the delays, the disproportionate availability of healthcare professionals relative to public demand, the constraints of what testing can be ordered (some are more expensive or need to follow a particular pathway of testing before they can be implemented) etc.
If you are concerned about a potential health issue, and you can afford to go private thus shortening your waiting time(s), fast-tracking testing and results and potentially also expanding or optimising testing, by all means go ahead. You deserve to have clarity about your health, and be able to access testing and/or a diagnosis in a timely and efficient manner.
If nothing else, going private reduces the load the NHS somewhat, benefiting those who can afford it or have health insurance, and at the same time freeing some space for those who don't have access to private healthcare. Many NHS doctors also do or have worked locum in the private sector, so in many ways its existence and use is great for medical professionals and patients alike. This is not an argument for privatisation of the NHS, however, the NHS is hugely important and access to healthcare for all is something that should be available the world over.
lovinglifeatmyage@reddit
I’ve done it a few times. Booked a private consultation then gone nhs for the treatment. And yes it sucks to have to do it.
Not sure if u can still do that, it was a number of years ago
paddlingswan@reddit
I’ve recently undergone ivf privately (as I’m over 35 so had no NHS option), and it’s thrown up a few things. The NHS GP has had to redo the relevant tests because they don’t take private clinic results.
TheAireon@reddit
Call me cynical but look at all these people complaining that NHS doctors told them there's nothing wrong despite them having issues.
Now imagine their reaction if a private doctor told them the same thing after they PAID a big chunk of money. There's clearly an incentive to diagnose so I'm not surprised everyone is coming out with a diagnosis after going private.
Could just be me being cynical though.
Forever-Fallyn@reddit
Yeah I'm sure those private doctors are photoshopping fake scan results and everything.
AnonymousOkapi@reddit
I went out of frustration when Id waited 2 years to see an NHS specialist then been completely brushed off by him when I finally did get an appointment. Took the referral recommendations from the private specialist back to my GP and she's been bloody brilliant getting them all put in place for me. I think it very much depends on the circumstances, and whether the recommendations fit with what the NHS would offer as first line treatment.
Inevitable_Thing_270@reddit
Most of the time, I’m absolutely not bothered. If you’ve managed to get things sorted and done before nhs can, then you’ve saved the nhs some time and money so good for us all round.
But it does depend on certain things too:
Blood tests and other tests on samples (eg CSF, biopsies, etc) : I need the all the results, not just the abnormal ones. And I need to know the lab that did them so I can find out they are accredited to do the analysis and there for results are worth the paper they’re written on.
None of that should be a problem. And if it is, then where you’ve got is dodgy/the person you saw knows nothing about what the specialty you saw them for
X-rays, mri, ct, etc: need the reports and access to the images. I’m not doing anything based on a report of images I’ve not seen. Again. Shouldn’t be an issue
Most physical conditions and many psych ones: usually not bothered. But again as long as I get good information from who you saw, that I can verify their credentials and that they know what they’re doing.
I have had one case where it was a doctor they saw, but the doctor vastly over stepped their area of speciality, and didn’t follow any guidelines at all (guidelines are evidence based so that’s why we have them), let alone do it with an understandable scientific reasoning. What the patient should have had was reassurance and advised clearly what signs to look for (they had panicked over something and booked an appointment with someone whose specialty could seem like the right thing, but his subspecialty really wasn’t. I have no reason to think he’s not good at his actual subspecialty). Instead did he went another way. Thankfully no harm came to the patient and they were fine. I can’t go into any detail because it was quite specific. So this is the kind of reason that the nhs maybe cautious at times
I’ve also seen cases where someone’s gone private for one thing, but that’s found something else that absolutely needs nhs involvement. Like someone who had a medical for a job before being transferred overseas, and the private medical uncovered cancer completely unexpectedly
Must admit that diagnoses around autism and ADHD are problematic at the least.
A proper assessment for these requires a lot of time, assessment of your current status and that in your past and childhood, often a multidisciplinary team with psychologists/speech and language therapist/a doctor with an appropriate background/maybe others to do it. And do it with the correct tools (eg validated questions to give an accurate diagnosis). And be able to rule out other issues that can look like them, or that can be present at the same time making the situation complicated (eg attachment disorder, personality disorders, ptsd, depression, anxiety, etc)
And sadly there are lots of places, often not with the correct resources, who will make the diagnosis quickly and inaccurately. Basically if you pay them, they’ll diagnoses you. It might not be what you want them to do, but it often goes that way. And the information that gets given to the nhs is often unreliable. Sometimes it’s a letter confirming that person X has a been diagnosed with ASD/ADHD and no other info.
It’s for this reason that diagnoses from the private sector are not accepted by the nhs, so that’s why you still need to go private for a things like adhd medications.
So generally I have no problem at all with it, as long as the information of validity is available and I can get accurate information. But there are some very specific things that are so often poorly done or not reliable that it’s just a no, I’m not going to use that information
Real23Phil@reddit
In partnership with NHS I never see (my GP), all my GP issues are noted, and I mention them at my 6 monthly neurology appointments, well I did, just do the chat now, stopped all bloods and MRI's while Palantir own our data.
Historical-One2407@reddit
I’m an NHS dr and have no problem provided the recommended treatment is standard and it’s not about queue jumping - that I disagree with!
DollySheep32@reddit
Not a doctor but a physiotherapist currently working in a private clinic but previously NHS - I really don't mind and having worked for the NHS I understand. Currently as its so underfunded I had a packed caseload of patients so I didn't feel like I could always give them enough time for treatment. A common thing is for a patient to have had something like a hip replacement on the NHS then come for private treatmemt but with NHS follow-ups with their treatment team there.
Green-LaManche@reddit
To answer the question: was working 40+ years as doctor: it doesn’t matter for us what and where you get treatment: but in majority of cases private doctors because are paid are showing extra care by highlighting things. My question to those are: if you are so smart why don’t you do it yourself? So they want to show extra care and cleverness on expenses of others overworked doctors. So if you are so clever- do it yourself and prove or rule it out.
ProposalSuch2055@reddit
The NHS tries to do as little as possible for as cheap as possible, that's not an insult it's just a fact. Private doctors and more willing to look into things in an investigative way & treat things at a lower threshold (because your paying them). The difficulty is if you don't fit into a neat tick box in the NHS it can be hard to get help, which is often why people end up going private, along with waiting times etc. Private doctors may therefore take a more detailed and comprehensive look where as the NHS is more likely to say 'unless you tick this box or meet this threshold we aren't doing anything', so it can be hard to transfer between the two.
jaanku@reddit
Part of the 2 min automated message I get when I phone my GP says something to the effect of “don’t expect us to do anything about or care about anything that a private doctor says”
WildWanderingRedHead@reddit
I've gone private a couple of times initially for a diagnosis and then they have referred me back into the NHS for ongoing treatment to save me money. No issues.
Sweet-Economics-5553@reddit
TLDR: BUPA and dinosaur NHS GP missed a serious illness. Young female NHS GP had me diagnosed and treated within 2 weeks.
My old NHS GP, who was awful, used to charge £150 per letter for private insurers. BUPA would only refund me £50 for the letter and then tell me they wouldn't treat me so I was then even further back on an NHS waiting list and £100 out of pocket.
Turns out, I was quite seriously poorly (the alopecia should have been a warning sign, but the awful GP just dismissed it and refused to refer me to a dermatologist), it took going a different, young, female NHS GP who had me diagnosed in 1 visit and referred me to specialists immediately. Within 2 weeks the NHS had basically given me my life back.
WinterGirl91@reddit
Not an NHS doctor, but my private healthcare paid for a private consultation when my GP surgery were being idiots. The private specialist worked part time NHS and the rest private, and they were horrified at the advice my GP had given me. The GPs advice totally mis-interpreted the NHS guidance and put me at significant risk of developing cancer as a result of not offering a fairly minor prescription.
Specialist wrote a strongly worded letter to the GP and I’ve saved it for the next time they refuse to prescribe in the same circumstances. The GP did take heed and fall in line.
AbbreviationsCold161@reddit
Would be genuinely interested in this too, having resorted to private care when told to go away by my GP on a couple of occasions, one of which resulted in my sinuses being drained, bone spur in nose removed etc...such that ai can breathe through my nose! GP suggested a nasal spray.
Canipaywithclaps@reddit
We don’t judge, as a doctor I wish I had a salary that allowed for private healthcare but don’t have the money spare right now. I sometimes bring it up to patients as an option (depending on the situation) if I think they are likely to be able to fund it/have access to insurance through their jobs.
The NHS only funds things when it gets bad, it’s not individual doctors faults, we aren’t given the resources for preventative medicine.
I’ve got a list of about 5 things I want to get checked out/get treated, when I have both the time and money to see a private doctor, none of which would warrant being seen by an NHS doctor.
smiley6125@reddit
This is what I am looking at. I have been to GP once and they gave me antibiotics. I just feel like a burden and am fortunate enough to be able to pay for a £200-300 consult. Breathing through my nose is hard therefore I am a mouth breather
Violet351@reddit
I have health care through work and when I needed allergy testing to find out which spice I was allergic to my doctor said they were her favourite words
wanderingmemory@reddit
I get the sense it's the old school British style of medical education to not do unnecessary investigations. So perhaps your GP is a bit miffed about that rather than doing something in private first.
(Context: Not an NHS doctor but I did med school in an ex-British colony and you could really tell a difference between the generation of doctors who were educated in the colonial days -- typically the ones senior enough to be conducting the exams so we had to learn the Correct answers -- and the generation who wasn't, typically the ones who did more of the day to day stuff haha. Classic example: suggesting an unnecessary autoimmune panel would get you scolded by a senior, ask me how I know...)
It is common however for private doctors to suggest unnecessary investigations so your GP wasn't wrong on that front. Have seen that many times too
As for your specific situation, obviously not medical advice and not for me to say without seeing the results etc etc. But in general, a thalassemia trait is mostly relevant when you want kids and your partner also has a trait (the kid could end up with actual thalassemia rather than just a trait which is whatever) so I would also be like "meh" unless the patient was trying for children.
yourefunny@reddit
My mum was a nurse and if I remember correctly lots of docs and nurses work for both the NHS and also private, or used to back in the day. So I would say it's a non issue. Have had good and bad experiences with both private and NHS. I think if you want it's best to get tests you are worried about privately. Even some private hospitals just aren't prepared for certain things and will send you to the NHS.
robinscotland@reddit
At least in the UK, pretty much every consultant you'll see privately also does NHS work.
At least, that is my experience with private hospitals in Scotland.
ToughImprovement276@reddit (OP)
Yeah this is why I find the disdain a bit weird, because ultimately they’re all colleagues and my private consultants often give me the names of NHS consultants to try and get into their clinics when my insurance won’t pay out anymore.
disneyadviceneeded@reddit
It’s because medicine is like every profession, you’ve got some amazing doctors who are very good at their job and clearly love it. But you’ve also got the opposite. Which is likely why your private doctor has given you names, those are the doctors who they know are good at their job. There will be some shit private doctors out there, but for the most part if they’re shit, people won’t go back and they won’t make any money (in fact they’ll actually lose money as they have to pay for the facilities and staff).
I’ve been going to my GP for painful, irregular and heavy periods since I was 13 and the difference between them as I’ve seen different ones, moved practice etc has been staggering. Even within the same practice, I had one tell me I was just being ridiculous and that’s just what periods were, went back and the next doctor referred me for an ultrasound and started discussing a possible endometriosis diagnosis.
Weird_Fly_6691@reddit
My physio from NHS started denying private doctors diagnosis. I went private because NHS waiting list for the procedure was not less than 13 weeks and I was in pain (was on a sick leave and couldn't wait for 13 weeks)
kbeavz@reddit
i went to a private doctor about something aesthetic recently (wanted a mole removed from my face that is benign) and he found a suspicious mole on my back. sent an urgent referral through to my nhs doctors who then rang me to ask me why i went private and they wanted to let me know i was always welcome there. i was like hun that might be true but that’s not always the impression i get when im back again trying to figure out all my ailments lol. surely they’d be happy people are paying private to take the load off them?
ToughImprovement276@reddit (OP)
Haha I have the same issue. Confusion as to why I went private but annoyance when my multi-faceted issues don’t fit neatly into a 5 min appointment scheduled for months in the future.
kbeavz@reddit
Absolutely. I felt like I was being chastised but usually my nhs doctors just favour a “wait and see approach” but i usually always go after ive done that and fully documented my symptoms. i even asked my nhs doctor about this particular suspicious mole back in january at the end of an appointment and she just fobbed me off
k_bee@reddit
As someone living with Endometriosis (it took 15 years to get a diagnosis in the first place) I rely on private healthcare for certain treatments. However, private healthcare is only good for clear, defined treatments (i.e surgery) and not on going care because of the way it’s set up. If I’m having a terrible flare up and need pain management I cannot go private - I’ve tried.
It’s mixed. Most, sensible, doctors know that the waiting list for even an appointment to see a gynaecologist - not even an endo specialist - is a year+ long and don’t get me started on surgery. But others get sniffy about it.
After my second surgery I had extreme pain about 4 weeks later. It was an emergency as I couldn’t move and a female doctor almost refused to treat me because I had my surgery done privately - I couldn’t believe it. I now don’t offer that info unless I have to. I met my current consultant when he was treating me on the NHS but I used private healthcare to bring my most recent surgery forward as I was in too much pain.
It really depends on the doctor but you would hope most of them realise the state of the NHS and that people who can should be able to get answers quicker. And maybe the private system/insurance can pick up some of the more chronic stuff
HowlInWinter@reddit
The private consultant I saw for initial diagnosis is also the consultant I now see on the NHS for ongoing care.
He didnt seem arsed about me starting off private.
Ugglug@reddit
My partner used to have private insurance through her old job. Her NHS GP was fully supportive of her going private as she has a complex mix of issues, she even recommended specialists have special interest my partners conditions.
The GP was then perfectly happy to carry on care once the private consultant was happy with the current meds/levels etc.
imtiramisu2025@reddit
I guess it depends on what is found. I have a few diagnosed conditions all which my GP initially refered me to a specialist for but I didnt want to wait a year to be seen so have gone private. I then go back to the gp with diagnoses. These are life impacting conditions some pretty serious. I have never had any issues they seem pretty on board.
If i was an NHS gp and people where getting health checks and finding slightly off optimal results in random things and then getting people requesting treatment id probably get annoyed too. The nhs has to prioritise and although we all deserve the best care the money isnt there.
That being said a thyroid panel test is so easy to do, i have hashimotos and it is in the NHS best interests to diagnose and treat thyroid issues before they become a bigger problem which will cost more.
Like with any job sometimes you just get dickheads. Thankfully not my experience.
ThurstonSonic@reddit
It can be an ideological culture clash as well. I had a slab dropped on my foot at work past the steel toe. Fucked my foot - went to minor injuries unit to get it checked out. The nurses that were running it did X-rays and told me it was just bruising. I was like I think it’s more than that can you get a doc and it was a no. Anyhow turns out I get private health care at work at the time - I know the foot is not good - get told I have to get a referral for it to be looked at. Rang up the minor injuries to ask for a referral from the nurses and it was a straight ‘ no we don’t approve of private medicine and you don’t need any further treatment ‘ Told BUPA and they were ok - let me see an orthopaedic doctor - chipped bone and separated joint which had to be carefully treated as they were talking about fusing it.
Always been wary of the NHS since and pay for private if can afford it - got to prioritise health.
WatchIll4478@reddit
It’s fine when patients have seen someone decent who I would happily have referred them to. It’s not fine when they have seen some quack for a wallet biopsy and been wound up to chase stuff they don’t need and can’t afford.
YellowOtter26@reddit
I’ve had the opposite experience for the most part. When I need a referral to a speciality or a consultant for something, the GP has 90% of the time asked if I have private health cover and suggests using it when I say yes.
I was diagnosed privately with ankylosing spondylitis and had to switch to the NHS for treatment as my private insurance wouldn’t cover it, and it was super easy. I had to wait a bit (~5 months) but otherwise it was fine, and the GP didn’t bat an eye when I came to them to ask for the referral based on the private consultant’s letter.
ToughImprovement276@reddit (OP)
That’s fantastic! Good to know it isn’t a universal thing!
too_weird_to_live@reddit
Private labs aren't as regulated as NHS labs, so blood results might not be accurate. The NHS will often want to repeat tests etc. I don't work in blood sciences but I do work in a NHS Histology lab (where all biopsies etc go) and we find that patients often want to transfer care to us as private becomes too expensive, but the labs aren't willing to release samples to us for testing, they want the patient to remain with them because they want the money. Some of the samples we do receive are poor quality because the private labs aren't held to the same strict standard as us.
"Shared care" is also an issue, I'm unsure if it's NHS England or integrated care boards that will just flat out refuse to accept a private diagnosis. I do tend to be on the NHS's side, private healthcare is a business and they want your money, so who's to say they aren't just telling you things that will hopefully make you (the patient) spend more money with them.
ToughImprovement276@reddit (OP)
This is interesting to know, especially in regards of the labs! I’ve had tests repeated on the NHS which I’m completely fine with, it’s more my doctor’s reluctance to look into anything that’s come up as a result of a private appointment.
I’d use the NHS for everything to save myself the hassle but considering I’ve been on a waiting list since November for endocrinology, it just made more sense to go private for what I could.
AnxiousStay1195@reddit
I don't understand why you're paying for a premium service that won't actually provide you with that service?
ToughImprovement276@reddit (OP)
It’s a benefit through work, so I only pay the tax and an annual excess. You’ll find that most private medical insurances in the UK won’t cover chronic conditions for legal and economic reasons. For anything acute, including cancer, I get full end to end coverage under my policy.
Classic-Mail4202@reddit
Interesting conversation. It became obvious that my husband most likely had Parkinson's. GP referred him to neurologist and there was over a year's wait. Paid for private appointment (same Dr he would have seen anyway). Parkinson's diagnosed that day with the result that my husband could be started on medication (NHS). Saw the Dr a couple more times privately and then the referral appointment came through (about 18 months after GP referred him). In my view that was well worth looking in to getting a private appointment, otherwise look how long it would have been before he commenced treatment.
Beginning_Ad_1723@reddit
Maybe you should ask the NHS doctors who also moonlight as private doctors what they think?
Massive conflict of interest and it wouldn't be allowed in any other industry
IWishIDidntHave2@reddit
I think one thing missing from this conversation is the concept of liability. The NHS self-indemnifies for care it provides, so there is no real risk in accepting a diagnosis from one NHS doctor handing over to another. However, private doctors are required to hold private indemnity insurance. If a patient is privately diagnosed, but publicly treated, the liability boundaries in the case of misdiagnosis/mistreatment become blurred. The NHS will never (rightly so) allow public ownership of risk arising from private profit bearing diagnosis.
ToughImprovement276@reddit (OP)
So this I can really understand and do appreciate working in insurance myself, liability is all I ever think about lol.
But I guess I find it weird in the case of my small blood cells, my own NHS blood work from the past shows the same thing and my GP won’t investigate at all. I’m probably missing something, but all the GP needs to do is repeat the blood tests and order a few additional diagnostic ones. It’s that sort of thing I can’t really understand.
saswir@reddit
Couldn't care less and wouldn't affect my management/decision making.
I treat the patient in front of me
ToughImprovement276@reddit (OP)
Wish you were my GP!
saswir@reddit
Not a GP unfortunately :)
Toughest job in medicine and I'd never last.
ToughImprovement276@reddit (OP)
Very understandable! There have been a few fantastic GPs at my surgery but they tend to leave quite often, probably due to burnout.
Well whatever type of doctor you are, if I ever need help from that specialty I hope the person has the same mindset as you!
bindulynsey@reddit
I was lucky and the same consultant privately and on the NHS. He would also request stuff on the NHS that came from a private consultation.
ToughImprovement276@reddit (OP)
With my latest health problem I’m really hoping this is the case, as the dr I saw privately was fantastic and she did say that she’d try to get me in her NHS clinic for better continuity.
Glad it’s worked out well for you!
w-anchor-emoji@reddit
I got diagnosed privately for something that the NHS would have taken ages to diagnose (and my symptoms were making me legitimately contemplate suicide). My GP accepted the diagnosis, got me the medication I needed, and got me in the NHS system with a hospital doctor and whatnot. It went very well, and everyone was very understanding of my reasoning and has not (to my knowledge) held it against me. I am getting the treatment I need, and I’m very grateful for it.
HairyN0sedWombat@reddit
Not a doctor, but UK specialist nurse. IDGAF and nor do any of the consultants I work with. Wouldn’t really even be a thought.
Never noticed any disdain or mistrust.
Mediocre-Spell-6090@reddit
I seen rheumatologjst privately and she referred me to ultrasound my neck and lo and behold, had cancer in my thyroid. She booked me in with a really good thyroid surgeon two days after she told my biopsy results.
Surgeon booked me for surgery. Asked if I wanted private or NHS and I said NHS. He did the surgery in the private hospital under NHS. It didn't make any difference to him.
Yuji_Ide_Best@reddit
Ive worked with 3 of the main PMI in the UK.
If anybody wants to query the insurance side, just ask. Ill get back to responses later today
BG3restart@reddit
I saw a doctor on Monday and in addition to medication and blood tests to rule out certain conditions, he suggested I self refer for physio. I filled out the online form and waited the requisite time until today when I was permitted to phone for an appointment. The earliest available was September, so I'll be going private as I really hope to be cured long before then. I used to have private health insurance through work (now retired) and whenever I needed to see a specialist, my GP was always delighted to refer me.
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