To think that if you are paying to see a consultant privately......

[GrimpenMire]

.....and you sent him a timeline/summary of your condition a month before the consultation date. It's reasonable to expect him to have read it prior to the consultation or at least be prepared to read it in the consulation so he has all the background information he needs to be able to help you.
He had a summary of it in front of him but he hadn't even written that summary. It was clear as he was squinting at it and trying to understand. The upshot of this is that he didn't 'get' the problem at all. Had he read it, he would have got it. AIBU or cheeky to expect this of him. £240 that shitshow is going to cost me and I'm no further forward.
He wanted me to fill hi9m in on all the background but I wrote the summary because I'm off my tits on pain relief and didn't want to miss anything out.

A decent consultant doesn't think this way

It’s not the consultant, it’s the sector. It’s a very profitable business and the business model is to deal with the simple stuff quickly at the maximum profit. Complex cases are less profitable ergo it doesn’t want them.

I work as a locum private secretary (and have done for a great many years). I am afraid they very often don't bother to do more than skim patient's handwritten histories. Mostly I will have a quick read through and suggest they do too but I know full well they are not likely to do so as they do prefer to get a history directly from the patient. If it is actual copies of previous results, they will read through them. We do get several patients who send in pages and pages of their symptoms from time to time - obviously, we do read them but they almost always the same symptoms they already discussed and include vast tracts of minutiae of no relevance at all to the clinician, i.e., "I went to the shops on Tuesday and had my niggly pain again when I bent to pick up my shopping, etc. "

With regard to your consultant wanting you to have a test you had already had with a colleague - if you had not had the investigation for a few years, it would probably be worthwhile repeating to find out the current situation. Also, we often get patients who have had (for instance) a private MRI scan at a local scanning centre (usually part of a cheap chain - cheap for a reason) and the images are really poor and the report has usually been done by a radiologist not particularly specialised in that area of the body and is pretty unhelpful. In those circumstances, the consultants I work for would suggest another scan on a different scanner just to see what is really going on and would need it to be done by a radiologist they knew to be accurate, suitably skilled in that area and who would give them a "proper" report. However, with self funded patients (who cannot afford to continue in the private sector), the consultants I work for would suggest they ask their GP to refer them to a local NHS consultant (they might have a colleague they can suggest or some of them might also work in NHS and would suggest GP refers the patient to them at NHS hospital). The GP has to do it - this is the rule - a consultant in private practice cannot make a direct referral to a colleague in NHS, nor can he/she switch that patient from his private practice to his NHS practice without the referral letter from the GP addressed to him/her at the NHS hospital address. The private consultant would usually be quite amenable to sending copies of results from tests he had arranged and copies of his reports to the "new" consultant in NHS to help them treat the patient.

I am sorry you found the consultant you saw unsympathetic - I agree, some of them are (and I heartily disapprove). I do hope you can get some help.

I wouldn’t expect them to read in advance but I would expect them to read it in the consultation.

How long was the information you sent?

And how waffley?

It sounds like you have had a terrible time and are continuing to suffer but you also sound like you have a huge axe to grind with previous clinicians.

Paying privately doesn't always get you great bedside manner or a "better" doctor.

Sometimes it isn't even quicker (thinks of the time I went in to work at 02:00 along with a surgical colleague to deal with an emergency to be told the patient didn't trust us because were NHS and wanted to be transferred to the local private hospital.

I was pretty surprised as their condition was urgent and likely to deteriorate/cause complications if left untreated. There was also no way they were going to get their surgery overnight in the private sector as they don't really provide a 24/7 service for emergencies and our outstanding^^ (thanks CQC) team was already set up & ready to go. )

Sadly, private or not, I've found doctors generally don't want to "read" notes beforehand, nor listen to you explaining why you're there. They want to ask questions in the order they want to ask them. It's infuriating when I first say, I've had x problem for 3 weeks, and then ask a few questions and then ask how long I've had it. I've had the same experience with doctors and consultants, whether private or NHS - they don't listen to you at first and seem to prefer to "tease" information out of you as if they're working through some mental checklist in their head.

Worst case was a specialist NHS cancer consultant who my OH was referred to. Despite months of tests, treatment, etc., the consultant had literally nothing in front of him other than a short referral letter from the local oncology unit doctor which basically said, please see Mr x, he was diagnosed with xyz 6 months ago. So the entire first consultation was just a Q&A session which concluded with the consultant sending him for exactly the same scans, x-rays and blood tests that he'd already had done at the local hospital. Crazy!

Mrsjoyfulprizeforraffiawork Thanks for your post. There are elements of what you have put in the mix for me certainly. I will go back to him if I have to but I am exploring another option in the meantime.

I think it’s reasonable for him to look at it as you sent it to him. My experience is the guy I saw wrote my history down as part of the consultation , but my situation was not complex.

My situation has gone on so long and there have been so many mistakes made I am thinking about writing to the NHS as I think I have the right to have these implants removed. I can't get well with them in place. Failing that, get lawyer to help me somehow. I don't know where to start with that though.

Failing that, get lawyer to help me somehow. I don't know where to start with that though.

Start with a large bank balance if getting Solicitors involved I'd have thought.

You should have taken the summary on with you for you to refer to if you were going to struggle to answer questions

I have had a few private consultations and tests. Even if he had read the letter he would still have got you to answer his questions because they want to hear it directly from you again. If the letter was that important I would have taken a copy with me and handed it over if you couldn't summarise verbally in that time.

Even in the NHS you can be referred again for tests as they want an up to date version or want to get another done with specific instructions.

Going to the consultant privately to get a quick first pass and then transferring to the NHS with a long wait isn't unusual but you effectively only bypass a small part of it if you can't or aren't prepared to fund the rest privately.

It does sound like your expectations weren't met but I do wonder if that it because you had a fixed expectation of them simply confirming what you had decided rather than understanding that the consultant would want evidence (his own scans etc) to reach their own conclusion in time.

Ive done work placements in private and nhs and the diagnostic equipment in private was over 30 years old while NHS was state of the art.
Yanbu op...complain profusely..

BritInUS1 WobblyAllOver I did take the timeline in with me. He asked questions and I answered them as best I could. I offered him the copy I had but he would quickly move on so clearly he had no interest in getting to the nub of the issue/. He asked me if anything had changed since the scan images he was looking at had been taken and yes they have. I have deteriorated to the point of being virtually bedridden but he didn't even let me answer that. Do you see my frustration?

I’d complain. Did you go through Spire or Bupa? They will have a patient experience team

OP, you seem to have made your mind up that YANBU - so why bother posting ?

I agree with the comments of @WobblyAllOver and @mrsjoyfulprizeforraffiawork, so I’m not going to repeat them.

I think it’s absolutely correct when dealing with bitch jobs of any kind really (not just medical) that you take nothing for granted. I’d trust no ones opinion / recommendation who cane before me. I’d want a full history direct from the patient and to make my own determination about what went wrong, why and how best to fix it. If someone doesn’t do this, starts to operate and finds that the situation is different to that expected things can get significantly worse very quickly. It’s this guys insurance and reputation on the line. You’d soon be suing him if it all went wrong I bet.

After I gave birth the first time my nhs drs gave me done advice that put the fear of god in me. I went straight to a private consultant who actually bothered to scan me, advised me I needed nothing doing and he was right. If I’d have followed the nhs advice I could have ended up with all kinds of significant surgery and unable to have my second child.

Also, I know £250 is a lot of money to many but in my previous job the charge out rate was way in excess of that. It’s not a lot for private consultants, top level solicitors etc... It sounds like you just can’t afford this and have fixed (and incorrect) ideas of how the private system can work.

There are bad private doctors out there (as in any profession) but I suspect you just didn’t like this guy and his manner, and had a fixed idea in your head as to what you wanted him to do.

I find it frustrating when NHS doctors haven’t done that but understand time constraints so would be pretty pissed off if someone I’d paid hadn’t done that

I had a similar situation. Paid £250 for private consultation but my medical history, issues etc were discussed at the consultation. I had a 45 minute appointment but everything was covered. He's a leader in his field and the appointment went well.

I went private - and though insurance - recently for a problem. Had the appt, procedure and follow up quicker than I would’ve even got an appt through on the nhs.,All sorted in 3 weeks. Longest gap was waiting for results.
Private does mean quicker, but the doctors all practise on the nhs too so you’re not getting a better ‘class’ of consultant really.
I’ve seen good and bad in both sectors.

Nobody knows whether your notes would have helped with the consultation. We don’t know the condition or nature of the consultation you booked. But he would probably state that notes from a lay person cannot be used as a diagnostic tool. He had to ask questions directly and in person.

Diagnostics tools, algorithms and so on, are used but these will be a set of questions given to you before the consultation.

If you intend to complain then be clear what the complaint is about. The surgery or the care you have received since. The NHS won’t respond to the issue you have explained on here. You also need to think about what you want to achieve. By the sounds of it you want more surgery. If so, like with the experimental surgery you agreed to, it will come with risks and uncertain outcomes.

@GrimpenMire I've had private cover for over 35 years and used it a lot. I have also paid for consultations that were for conditions not covered by insurance. My family have done the same so between us we have used private cover x 4 adults for 35 years.

I've been very happy with all my consultants bar two over all those years and never went back to them.

I don't know if you are still reading or open to advice but there are a few points.

The first is that if you went via a GP, they ought to have written a summary of what your have and tests done.
Did they?

The second is that you usually get around 45 mins for a 1st appt with a private dr. He may have felt he wanted to cut to the chase and the options of investigations you were fairly limited, regardless of what you told him. Does that make sense?

I agree that he could have read your notes beforehand BUT some people prefer to scan them quickly and talk to the person face to face. We don't know- with respect- what your notes you wrote were like. Playing devil's advocate - really!- they could have been jumbled, illiterate, hard for him to understand. We don't know. I'm not saying they were, but in principle a dr could get something in writing from a patient that was unclear.

As you didn't self-refer but went through your GP, the onus was on your GP to send that summary.

I think you have just been unlucky. There are good and not so good drs and they work in the NHS and privately. Some have great bedside manners, others less so.

My advice would be that if this dr didn't measure up, you find another one. Choosing a consultant if you are paying is like anything else- buying a house, buying a car- you need to shop around to find one you like and who is good. Obviously this can be expensive and it's not an option for everyone.

I think you could contact him and your GP and politely state that you felt you weren't given enough time in the appt to convey your condition - if that's the case.

Presumably you weren’t the only patient in the clinic though? My OH is a consultant and saw >100 patients in clinics yesterday, and was out of the house for 15 hours to do it. If he had read summaries in advance of the clinic for all of those patients, it would have a) taken forever, and b) there’s a good chance of getting people’s info mixed up. Far safer to read things just before the patient walks through the door of the clinic or while they’re sat in front of you.

@Toomanyapplesinthefruitbowl Did you miss the whole point? This was a private consultation. Given most appts are for at least 35 mins for a private appt, and often 45- 60 mins it's unlikely the dr would be seeing 100 patients on that day!

That one appointment was a private one, doesn’t mean all of the others were though. Quite common to have one private patient tacked onto an NHS clinic

When I saw a private consultant she'd familiarised herself with my notes beforehand. Cost was £200 and appointment lasted about 40 minutes.

I suspect he was moving you on quickly when you answered him because you were telling him things he already knew or didn't need to know at that point, and time was limited. He probably also felt that the quickest way to help you was to find out precisely what was going on at that point by way of an up to date good quality scan.

I'm not a medic but I work in a field where I need to assimilate a lot of factual stuff from people I work with. Sometimes they send me reams of paperwork before they come and realistically I can do no more than skim it. They may also want to tell me in great detail stuff that is in the papers or historic stuff that isn't directly relevant to what they need going forward. I will listen sympathetically up to a point, but because time is limited I may well have to cut them off. What is important is either what I advise them, or what I do afterwards, and I know how to get what I need out of the paperwork for that purpose. I suspect this consultant may have been in a similar position.