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[Lisa1966]

Hi ladies,
As u may already know I have a private appointment on the 19th,as my gps are clueless about hormonal depression. However I have a gp appointment this Tuesday,I don't think it's a good idea to ask her to change anything,as I need to see what private man recommends,I'm also on the waiting list with her for mirena to be fitted,but I don't know if I want one anymore,as I can't afford to get anymore depressed,u can't just stop taking a coil,and getting an appointment to get it taken out could be a long wait. So do I tell her I have a private appointment or not,obviously I need to keep her on side,but I don't think she's gonna like it.just sick of fighting with gps. Also I darednt tell her I'm on 2mg,when she only prescribed 0.5

           Lisa xx

[Wilks]

Would it be easier to reschedule your GP appointment until after your private one? The private dr will have to write and tell your GP the details of whatever they prescribe or recommend for you, which saves you from having to tell the GP yourself.

[Daisydot]

Good advice Wilks that's exactly what I tended to do and I've done again this time,I saw my meno consultant a could of weeks ago got a private script to tide me over till I then get to see my gp and resume battle to get i5 on the nhs.
Not everyone has this battle Lisa so don't let it put you off there are some fine open minded gps around the ladies here can testify to that,I just happen to get all the arses.
I'd follow Wilks very good advice.xx

[Tempest]

In a nutshell - I'd say nothing. Don't stress yourself, go to your private appointment and take it from there. I'm sure your private consultant will write to your GP with their recommendations/what they have actually prescribed. It's your choice, and you're allowed to exercise it. Good luck! xxxx

[CLKD]

Ethically a Consultant shouldn't see a patient unless referred by the General Practitioner as patients are not always honest in their medical histories.  Which could lead to problems.

I would postpone the GP appt. and have a good think about what is suggested - the Consultant should take details of your GP and medical history of course but this is something to discuss at the private appt..

Let us know how you get on!

[SueLW]

Don't say anything before the event.  Wait until afterwards.  And as someone else said above, if you can, reschedule with the GP for a later date.  At which point you might have a plan to present rather than something vague.

[Hurdity]

That's an interesting point CLKD because private menopause appointments do lead to prescriptions for HRT and they do rely on a patient's honesty. However they do write to the GP ( I think as a matter of course -  the gynae I saw did and i presume others do?) so theoretically if there were any problems the GP could contact the patient and ask them to make an appointment?

Lisa - I would keep all your options open. There is no need to say anything to your GP at this point. Do keep your name on the list for the Mirena as you may decide you do want to try it and indeed your private gynae might suggest it. What you do want to know though is that the practice will continue to prescribe any HRT that the private gynae prescribes because you will want (and are entitled) to get it on the NHS after the initial visit - with the exception of testosterone if that is prescribed - this can be refused (by your GP) as it is not licensed currently.

If you are not due to take the progestogen part of your HRT before your gynae appt then, in the circumstances perhaps it is best to re-schedule your GP appointment - just tell them you can't make it or something? I think that could be a big part of the problem in your case (the norethisterone).

Try not to worry and you only have just over a week to go

Hurdity x

[CLKD]

When I was a Medical Secretary a Consultant wouldn't consider seeing a patient privately without a Referral Letter, even those based in Harley Street.  Patients may well tell the Consultant what they want them to know in order to gain a prescription which may, in some cases, not be suitable treatment.

Also, a GP may well strike a patient off their List if they go privately.  The NHS does not have to support private prescriptions.  However, I know of Consultants who saw patients in Private Practice who would send them back to the NHS after the appt., as there was nothing to be gained, other than peace of mind, by going privately.

It's about communication.  About being ethical.  Building a relationship between the patient and GP, though in Sept. I was unable to get through to a particular GP that I actually, didn't want statins!  [long story short].

It ain't never been easy .........

[dangermouse]

I used to have a private GP in house at my work and they would do any referrals. They were meant to send records back to my NHS GP but it was a bit hit and miss.

I've always sensed with my NHS GP that they were appreciative of me using other options (to save them money perhaps?) and they are happy to do bloods tests for any private appointments (even ones that they didn't refer) for maybe the same reasons.

I guess it depends if they see it as undermining them or another option you have to save them the hard work!

I'd also vouch for moving the GP appointment to after the consultant.

[Maryjane]

A big majority of the London consultants see patients via self referral , and they only write to the GP with the patients consent....I have personally self referred and my GP has always known and been absolutely fine about it , and she says she knows I take good care of myself re my issues especially VA , and where my VA is concerned I have done whatever has been needed , so have any quality of life with it.

[Lisa1966]

Thank you ladies,
I was thinking maybe if I went to see the gp on Tuesday,maybe I could get some blood tests done before private appointment

      Lisa xx

[Wilks]

Any private doctor who didn't request your GP's details and write to them afterwards would be ethical, but you CAN legitimately self-refer to some clinics. I've seen a migraine specialist at the National Migraine Centre, a hand surgeon to look at a wrist injury, and a menopause  specialist- in each case I self-referred and the specialist in question wrote to my GP.
In any case it saves the GP surgery money- it costs about £300 for a surgery to do a referral even a referral to an NHS specialist.

[Daisydot]

I'd still wait Lisa because if you need any tests done mr Parsons can request that your doctor arrange them on the nhs because he is also a practising nhs consultant,he also requested my dxa scan which showed my risk of fracture due to falls I'd had and also showed I had oesteopenia in my hips and spine which I was never told previously having had X-rays done via the nhs.
He will with your consent do a full written report with his recommendations to your gp as I told you before,I'm sure I did lol,he will also copy you in if you ask him,you can then go in to your gp armed with the knowledge in your report and discuss your regime.xx

[Lisa1966]

Thanks daisydot,was just trying to cover all bases,I didn't want to pay anymore money for tests and things.will it just cost me £195 on the day?obviously I know I will have to pay for my prescription at the chemist,so I have to pay extra for him to give me the prescription? God I am a worrier  xx

[Daisydot]

No you won't pay him anymore than was outlined to you when you made your appointment.If he changes your meds and you want them immediately then yes you'll pay the prescription charges but if your prepared to wait until you see your gp then you could see if she's amendable to you having them on the nhs,it's all very hit and miss with gps Lisa I can't say if yours will agree to follow his recommendations,mines wouldn't until I wrote to practice manager then they did a complete uturn,even going so far as to say they were concerned about my finances it was all bull but I had to battle with them and I'm still battling,Ive another one scheduled for tomorrow which I'm dreading but I've no option with them.x