Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Taz2]

Isn't private practice different though? If you are paying through health insurance then a referral from the GP is necessary but if you are paying personally then no referral is needed - although, obviously, it can help  as it bypasses the need for tests which may have already been carried out.

Taz x

[CLKD]

Perhaps it is different these days but it is un-ethical.  Also could be dangerous    ......... a patient might with-hold important information which a GP would probably include in the referral letter!

[Taz2]

The BMA does stress that a referral letter is the best way but it is possible to get treatment without one if you prefer.

http://www.nhs.uk/chq/Pages/892.aspx?CategoryID=68&SubCategoryID=158

Taz x

[CLKD]

 

How things change!  I think it's dangerous practice 

[ellie66]

No you can self refer privately and yes it is ethical. Also you can tell your GP not put information in a referral letter and you can stop your GP sharing information with another health professional. You have the legal right to confidential. This why patients can opt out of the Summary Care Record. Medical ethics is may day job! A&E see patients safely with a referral. They have protocols in place to ensure they cover every eventuality. If you are unconscious with no ID they need these protocol as otherwise you would never get treated. Any Consultant would know the right questions to ask as would any doctor in general.

My own GP knows if I had something personal I did not wish to discuss with him (he is colleague) I may go off privately. He is very happy with this. The Cromwell have actually said to me (they know I worked in the NHS etc) if you need to see a Consultant contact us and we will speak to the Consultant. If the Consultant wants a referral we can sort that out later.

In the US patients regularly self refer. It is just the NHS that does like it however there is nothing unethical or unsafe about it.

EDIT: My own GP has said to me if he needs to make a referral to let to tell him if there anything I want omitted from the referral. He is medically famous and he has renown from his interest and expertise in medical confidentiality.

[honeybun]

Good post ellie.

I did not know half of that.

Than you

Honeyb
X

[Rowan]

I found Ellie66s post very interesting and informative too and I am going to copy it.

Thank you too.

[CLKD]

   but there is a difference between it being legal and ethical.  My GP knows stuff about me that even my DH doesn't and there are certain organisations who can insist on seeing complete Medical Records, i.e. Insurance Companies in the case of an accident claim.  They will insist on seeing EVERYTHING and if a claimant refuses then the Company will not pursue the Case.

I can understand why patients would want to keep stuff private - I have a great need for confidentiality myself.  Because I worked in the NHS and later in PP and in those years needed to see Staff where I worked, it all got a bit complex  . It wasn't as easy to move hospitals in those days ..........

now - the query was? 

[ellie66]

NO ONE can demand to see confidential medical records even insurance companies. You can always refuse consent. You can stop your medical records being shared. There are very few exceptions to this main one being a court order.

The NHS insists on a GP referral as GP'S are the NHS gatekeepers to keep costs down. However you can still instruct your GP not share information with your Consultant and vice versa. A referral is not necessarily necessary if you paying yourself privately. 

EDIT: We are conditioned in the UK to think you always need a GP referral you do n't. In lots of countries like the US referrals are rarer. In the US patients pick their gynae Consultant and make there own appointments./

Anyone interested google my colleagues at medconfidential . org a health NGO to see how NHS records are used

[CLKD]

In the US there are many hoops and swings to jump through in order to get Health Care Insurance which is why there is more freedom to choose health professionals.

If a patient doesn't want all the medical records to go to an Insurance Claim then it is very unlikely that the Claim will go through.  I have seen a few thrown out at the early stages because the accident victim doesn't want to share information.  Insurance Companies often hinge on the slightest health issue in order to not meet Claims  which is why they insist on seeing all info..  It doesn't take a Court Order every time - the Insurance Company simply writes to the Consultant who is preparing the Medical Reports and states that 'this Claim will not continue without full sight of medical records'.  Gosh, that takes me back to when I typed Medical Reports every day ......  usually whip lash claims from RTAs however, I digress .........

[ellie66]

My point is more general patient can still withdrew their consent, and stop the insurance company accessing their records. Yes the claim may not go through but a patient can make the decision to stop the claim if their is something highly personal in the notes. They can also ask for the GP/Consultant to withhold information from the report. In the US if patients do no want there insurer to access gynae info they can easily pay privately without any referral.

My point is a general one patients can control their medical records and you do not necessarily need a referral.

[Js]

Hi all

Interesting reading think I have the same problems but I find that I can't be bothered  to do things lately and feel I don't have any friends as we don't go anywhere or do much due to work and family life haven't had a holiday this year and my motherin law died in April and feel I need to have a break after a very busy stressful 6 weeks at work during school hols not because of children but hassles at work I sometimes think. Need to speak to a counsellor or try to say May be it's my hormones I am 54 married have a 16 year old teenager and work I'm on hrt patches have been for about 3 years so could it be a need a change of that although I seem to be ok on it but might have a word next review time sorry I'm ranting just want to know if anyone feels the same or is it me everyone at work is younger than me and I feel their conversations are  not of interest to me although I do try to join in 

Js