Why are consultations so expensive?

[RainbowsAndCrystals]

I'm trying to see a dermatologist in London and pretty much every appointment is over £200. That's not even for a treatment

It's a decent price you've got there. I'd pay that so I don't have to waste my time in an NHS hospital.

They charge this much because they can and people will pay it. The NHS is far from perfect but usually works well in a crucial situation. Consultants in the private sector are not always the best in their field.

Example - in Scotland where I am, private health insurance will actually refuse to pay for private cos nhs is better. Example - a woman of 50 gets diagnosed with breast cancer. Surgery in NHS by breast specialist in less than 10 days then reviewed at multidisciplinary team with cancer specialist who suggests best post surgery treatment based on him treating 200plus women a year. Private hospital = nice furnishings and a China cup for your tea but consultant will operate on any tumour that he is getting paid for and won't necessarily have a specialist pathologist as part of the team. But I admit it works less well in elective cases like skin situation- terrible for the person but not flagging any breach of targets so not seen as important. Remember also NHS doesn't work like your home - if you "save" in a year you can't spend more in next year do spending towards the end of the financial yeah is always fwk2d up.

Supply and demand basically.

Because they're there to make money? Why would they offer their services for free?

It’s tgeir job, you are paying for years of study, years of experience, tgeir secretary, and fees they pay for their office, insurance cpd etc. Just because you have something they can’t treat doesn’t make these things disappear. They have still invested their time and resources st your request to work this out. I’d say £200 is a fairly cheap price for all of this. What do you think you should pay?

I'd be happy If they would refund it back if they decided that they couldn't help you

But you are paying for their expertise to decide if they can help you. Whether they can do anything more or not, they have still taken their time during the consultation. You have received a service- the consultation is that service. Do you expect that for free?

Ongoing treatment would count as a further service.

Are their many highly qualified professionals whom you would also expect to work for free?

Yes because I've come on here and said they should give me an hours consultation and then free treatment afterwards.

But you think they should give you your money back after a consultation? Why?

That's time spent on you that could be spent with a paying patient. You're paying for their services, for them to say "you have X, the solution is Y", or "You have X, but the solution is Z and that's not something I can help you with."

Why should they give you their time and help for free?

It costs approximately £170 for a first outpatient appointment on the NHS so pretty equitable as you will actually see the consultant and they need to cover their costs themselves private work has a much much higher indemnity.

To be honest I think they under value themselves.

I think that is a bargain I cost between £120-160 and hour and I only offer advice don’t even do treatment and I am a nurse.. yes you might have to pay for treatment after but chances are it won’t be the consultant treating you so should be cheaper and in fairness to the dermatology profession much of the time they can help you there and then.
And the good new if you don’t want to pay for it you can see a gp and see them on the NHS might take a while but that is the trade off.
Quick and expensive, slow and free only you can decide what you want to do.
But no point in moaning about the cost

I wouldn't trust a Dr who gave you the money back from a treatment

That's what cowboy cosmetic surgery clinics do with free consultations

That incentivises them to encourage patients to have costly treatments they may not benefit from, to cover the cost of the 'free' consultation

Yes because I've come on here and said they should give me an hours consultation and then free treatment afterwards.

No, but you've said they should give you a free consultation if they can't help you. I think you are missing the fact that what you are paying for in that initial consultation is the doctors assessment of your condition and whether they can treat it. You are paying for the consultants expertise, even if he outcome of that is that they can't treat you any further. I.e. you are paying for their time and expertise.

I also agree that I think that offering free initial consultations does run the risk of incentivising clinicians to offer treatments that are either not needed or perhaps less certain to help- in order to generate the income they would have got for charging for the initial consultation fee. Not that it would be excusable, as Dr's should always act professionally and in the best interests of their patients- but I can see how it could happen.

They have office space, overheads, taxes, pensions and holidays to come out of their earnings, and as well as paying for the training and experience they already have, there's ongoing professional training and insurances. They don't get to keep the money all to themselves.

It is quite a lot though when you're used to free at point of service.

People in this country just have no awareness of the cost of healthcare. When you see a doctor on the NHS the cost is still high but is covered by your own and other people's taxes.

I see a private consultant in a different area of medicine - it costs £300 for a 45 minute consultation. I've then paid anything from £800 to £2500 for the follow up treatment, depending on what we've decided to go for. I have a degenerative issue, and have finally found a consultant I feel 'gets me', but not in my local area... so I pay. He does give me a bit of a reduction as I'm self-pay (can't get medical insurance) but it wouldn't be a reduction of the consultation fee - his time and expertise is what I pay for.