To go private because GP won't refer me?

[JustGettingStarted]

I had a basal cell carcinoma removed from my face 8 years ago. It required a skin graft and left a scar the size of a 50p piece. This was in Scotland. I hadn't recognised it for what it was and left it several months due to being pregnant and then having 3 children under 5.

I was told at the time that I would likely get more and that I should be checked by a dermatologist periodically.

Then I moved to England. I have had very little cause to see doctors and I haven't been checked by anyone. But I keep an eye on things and I recently noticed a new, tiny bumpy patch very close to the site of the first lesion.

So I went to the GP this morning to ask her to look at the thing on my forehead and refer me to a dermatologist. She barely leaned forward in her chair and she was very dismissive.

She just said it's nothing, don't worry. I asked her to refer me to a dermatologist and she said no. No referral unless "it grows really big or starts to ulcerate."

She didn't even get up to lean over and really look at it. She just said that nothing would be done unless it looks like a carcinoma to her, a GP.

I told her that I have had one removed and was told I was likely to get more. I told her that I had let it grow last time and was told that I should have gone earlier. In fact, I was told that I should have periodic checks by a dermatologist. She said that wasn't going to happen in England.

I just can't believe that unless she thinks it looks like a carcinoma... After it's grown and gone scabby... there's nothing to be done.

So I am paying for a private dermatologist to look at it Friday afternoon. If a dermatologist who specialises in treating BCC's tells me it's nothing, I'll let it go. I also figured that I would rather get a carcinoma treated privately as then I would have control over the timing of everything instead of just waiting for letters. I was impressed with being able to get an appointment with only two days notice! I have to travel for my work and I like the idea of being able to schedule things around work.

I am paying 225. But if a dermatologist tells me not to worry, I won't worry, so money well spent. And if he thinks it is a carcinoma, money well spent! Alternatively, I can also request a referral to the NHS for treatment, thereby getting around the obstructive GP (should it be a carcinoma) while saving money.

But an acquaintance of mine believes very strongly that paying for private medical care is wrong because it perpetuates a two-tier system that favours those who can afford it. She encouraged me to seek a second opinion from another NHS GP.

I'm not made of money. I wouldn't be able to pay for anything major. But I can afford to pay a few hundred if necessary. I figure I'm saving the NHS money.

AIBU?

[bumum]

How did it go? Did the private dermatologist ease your mind or was there something sinister?

[CSIblonde]

Being dismissed, with your history, was poor. I had a dodgy mole that bled done privately. They test all moles routinely & luckily it was fine. Do it, it's not worth taking a risk if you have a history.

[ViaSacra]

A lot has changed in 8 years...

Part of GPs’ funding is now tied to keeping our referral rate under a certain level. If we refer too many people, we won’t get paid.

Your GP’s hands are tied. Her practice won’t be happy with her if she refers lots of people who turn out to have nothing seriously wrong - if she’s a salaried doctor as opposed to a partner, there could be consequences for her (e.g. less likely to make it to partner, if that’s something she wants).

She may well feel that she has to wait until it’s worsened to the point that it’s clear you need a referral, rather than referring pre-emptively. Which would lead to a worse outcome for you, of course, but the government would be happy. It’s a feeling I have to fight myself.

My practice is fortunate in having a GP with a special interest and extra training in dermatology, so anything we’re unsure about gets passed to her, for her to judge whether or not it needs a referral. But not every practice has that luxury.

[heath48]

I went to my GP three weeks ago,with a tiny lesion on my tongue,was gobsmacked when she made me an Urgent appointment with a Consultant at our local hospital,was seen in 10 days,all was well.

I would like to think if I had had Cancer before I would be referred automatically.

More than worrying the difference in treatment you receive,all depending on where you live.

[Doyley47]

The NHS is failing in some areas. You going privately will at least shorten the queue for someone who cannot afford to pay. You need to do the best for yourself.

[Branster]

OP you are doing the right thing and your friend doesn’t know what she’s talking about.
I don’t know if this is the case with your local health centre but, where I am registered, there are two GPs with an ‘interest’ in dermatology, one of which more so with skin cancer. I am not registered with them but I was able to see them specifically when I thought their specialism was suited to separate concerns at different times.
Could you identify a similar GP in your practice for the future? at least you will know a qualified person with real interest will who take you seriously and refer you accordingly?

[Undaunted77]

There are some bad GPs out there. Just like all
jobs, some are more competent and some are more thorough than others. No divine right to be treated as an omniscient saint just because you are a doctor. If I get a dismissive and/or ignorant GP, I just go straight to another one without any doubt or worry.

I learnt this years ago when the senior partner of our GP practice refused to give me antibiotics for a bad case of cystitis. I couldn’t believe what I was hearing so I went to another GP who gave them straight away.
Much later I found out the first GP had gone all David Icke and had turned his back on modern medicine...but he was allowed to carry on practicing for far longer than he should have been because of his senior title and because patients didn’t think to complain.

[Grumpyunleashed]

Yes go private, your peace of mind demands this is checked out ASAP.
If it’s fine then good. You will know and be happy.
If it’s problematical you can set about getting it sorted.
However, if it is problematical then I would complain to Practice Manager, Local Health Authority, whatever professional body licences GP’s and anyone else you can think of.
Medical professionals hold the lives of patients in their hands and they cannot be allowed to be blasé and negligent.

6 years ago dying MIL was discharged from Hosp back to care home to die with a large bag of drugs to swallow and NO care plan to guide the home in her treatment. This course of action was particularly impressive as MIL was catatonic, she could not eat, not drink, not swallow and was in the terminal stage of dementia and so was completely non responsive. Therefore, not surprisingly, unable to take drugs.
Due to the failure of the hosp the care home had no knowledge of the state of MIL as she had been in for 4 weeks and declined from eating and responding to being a discharged vegetable with 5 days to live.
Enraged at this neglect I fired off a formal complaint about the Hosp to the Quality Care Commission and got a 6 page letter back from the Hospital chief Executive a couple of weeks later explaining exactly how this had occurred, detailing how staff on this ward and others had been retrained and how matters would be taken forwards.
This complaint was not something I did casually, I can only hope that that they are still discharging completely vulnerable patients correctly and no one else goes through what my wife suffered because of this.

Finally why the QCC? So that my complaint could not be ignored by a busy Hospital. There are some things that cannot be allowed to slide.
It sounds like if your GP is wrong, your issue could be one.

Good luck.

[Derbee]

YANBU. We often go private, and then rejoin the NHS knowing exactly what treatment we need. It saves us time, and must save the NHS money.

Your friend is a naive idealist. Ignore

[PhilCornwall1]

@JustGettingStarted YANBU to do this at all. So what if you are "queue jumping"? I did it and make no apology for it.

I needed to be referred to a Rheumatologist by my GP. He told me it would be a three month wait. Fortunately I get private health insurance with my job, so I used that, I was seeing the Consultant the following week. Yes, I jumped the queue, but it's my health (and I have a wife a two children who were worried) and I was in a bad way. I'd do it again without a second thought.

If you have the means to pay or have insurance, do it.