To ask how can I avoid getting a junior doctor at my appointment tonight?

[Alrueb]

Firstly, I've nothing against junior doctors, not at all!

It's just that I have been dealing with life-altering symptoms for over 2 years now and I have been on a huge waiting list for 18 months - just for a first appointment with a consultant.

I have questions about surgery and would rather speak to the actual surgeon, given how long I've waited.

I am absolutely awful at being assertive. It's from PTSD and it's so bad that it affects many aspects of my life, including my career. I'm having therapy to try overcome this, but it's only taking me so far. It's only recently and rarely I've been able to speak to neighbours or anything!

Does anyone have any tips on what to say or how to word things? Someone said I need to ask at reception, I'm not sure.

Thanks!!

Write your questions down. Take a pen and jot down their answers. It will help you sound more assertive and get more out of the appointment.
Dont worry if the questions sound trivial or basic. You need answers and it will focus and structure the time you have.

Presumably everyone has been either waiting 18 months or has something more urgent. The consultant can't see everyone just because they've been waiting.

You will be seen by an appropriate qualified medical professional. If they cannot manage your questions they can speak to a consultant. There are many many surgeons who are not consultants, you will not be listed for surgery without seeing a surgeon

If you are really concerned you can ask to see a consultant, but you will obviously have to wait and may need to rebook to come back to a different clinic

If it helps I saw a trainer dentist and she was the best dentist I’ve ever seen.

Because she was new she was over the top checking all of my teeth thoroughly.

I don’t know how you can choose not to get a junior doctor but I would say a junior doctor is more likely to take you seriously and refer you just in case, than a doctor who has been practicing for years and is more confident in themselves.

This is why the phrase 'junior dr' needs to be phased out.

A 'junior Dr' is not an inexperienced trainee or someone just fresh out of med school. A junior Dr could have years and years of experience, including surgical experience. They're not 'new', they're just not yet a consultant.

DH recently had a consultants appointment and was seen by a junior doctor. The junior doctor said “well we’ll leave it 6 months and see how it goes”. DH asked why he was even there, as surely if it could wait 6 months, they wouldn’t have made an appointment for him.

So, his file was put back on the pile for the consultant to see, and the consultant did decide to act.

If I were you, if you are seen by a junior doctor, and they can answer all your questions, well and good. But if they can’t, don’t be fobbed off. Tell them that if they can’t answer the queries you would like to be seen by someone who can. Explain that you were told that this would be an appointment with a consultant and that you would like to see them today.

If she has been referred for possible surgery of course she will see a surgeon. Consultants are the surgeons as well as other members of the team. In my hospital you mostly get seen by a consultant for your first appointment and they may or may not do the surgery. Generally they have done the surgery for me but you see many people on the team and they all work together and discuss cases. You can also ask to see the consultant if you are really concerned. I generally get to see my consultants in out patients rather than their underlings . However, last time I wanted to discuss something with the surgeon who had done my op so asked the junior doctor who called me if I could see the consultant. He put my notes in the consultants pile and I saw him.

I would presume whoever has been allocated for your appointment has been allocated based on their suitably and your current need, I presume a referral has been made that outlines your current symptoms/difficulties and if further input/procedures are needed then the person best suited to you for your next appointment will then be allocated to you, I have had plenty of appts where I have seen my own consultant/surgeon and others where I have seen a more junior colleague of his, usually when he has been carrying out a theatre list where his patients need him much more than I do!

To actually answer your question, u should have rang the secretary before now to ensure you see the consultant failing than ask the receptionist when you arrive

I work with consultants and junior doctors, I would rather see a registrar than some of the consultants I work with tbh.

As a patient and staff member I find consultants very hit and miss, some are amazing, others are jaded, don’t enjoy the job any more and can be quite dismissive/arrogant. I think registrars tend to have a better bedside manner and are more cautious and thorough.

In my experience of eg NHS ortho teams, there is a team of three (one consultant and two registrars) on in the clinic, and it's however it falls on the day - eg every third appt is with the consultant: total luck.

Consultant might pop over to recap (that's more if you keep going back to the clinic) or registrar might occasionally check something with them.

But otherwise, and as PPs have said, the junior ones will have masses of medical experience (they might have years or simply months of specialist experience (they can rotate teams), but they wouldn't be there if they didn't show a competency for it) (I saw a junior ENT in January and she was brill). And all patients have their own issues (although I get where you're coming from, wanting to make the most of it).

Also, some of what seems complex to us is sometimes (not always!) of a surprising simplicity to a trained doctor. Oh, the pain of that bad ankle/the faff of the recovery time - and to them it was a yes you need this op, and it will take us about an hour/job done.

List of questions ready is a good idea.
If you feel like they haven't answered a key question, keep asking.
I also make sure I know beforehand how many minutes I'm going to get. If I am unsure of 10 things but they're trying to shove me out the door in two minutes, I start asking some of my questions.

That is a good point but I’m just explaining that even if they were new, it doesn’t mean that they won’t be good at their job.

They will still be trained properly and may have positives that a much more experienced doctor may not have.

I'm eternally grateful to the registrar who realised that my "tennis elbow" pain was actually referred pain from arthritis in my shoulder. A simple arthroscopy sorted pain that had plagued me for 8 years, and been dismissed by a previous orthopaedic as something that should have responded to physio and that I hadn't been doing my exercises.

As PPs have said, even a "junior" doctor should be fine, but if you really want to see the consultant call their secretary beforehand to make sure they're in on the day, then when you arrive explain to the clinic staff that this is who you want to see

I did this for years when taking DS for his appointments, and now we'be built up such a good relationship with his consultant that he won't allow anyone else to treat him

This isn't true, we are always seen in Dr X's clinic, but are rarely seen by Dr X.

I’ve found junior doctors more knowledgeable on my relatives rare medical issue.

if you don’t get the answers you want them just be polite and ask if they can check for you with a dr that does.

Yes you are the third person to tell me that.

My consultant has always been named on the letter but obviously other depts/hospitals operate differently 🤗

Sounds like you need to have someone go in to the appointment with you op, to reassure you that you are asking the right questions.
If you can't do that, make a list of all the questions you want to ask so you don't forget in the heat and stress of the moment.
And have some trust in our wonderful NHS doctors, they know what they're doing.
All the best!

Honestly the junior has the more recent training and is likely technically better than the consultant!

Otherwise pay your way.

I agree with @nether: it was a great day when DH was ‘downgraded’ to the registrars for his post cancer follow ups. And they were excellent. My own complex chronic condition was diagnosed, with an excellent treatment plan developed, by a registrar.

The consultant’s clinic prepares the list carefully, OP, and the registrars will bring any questions to the consultant’s attention. I have many doubts and criticisms about the NHS but whether we see consultants or registrars isn’t one of them.

No, she would have been told that she will see the consultant or one of his/her team. Call would be a waste of time.

@Alrueb If this is the first appointment with a consultant that you have had for your 'life-altering' symptoms only, you can't even be absolutely sure that surgery will the way to deal with your health problem, surely?

I appreciate that you are very anxious about it, but try to be reassured by what other PPs have said and take the appointment, with someone with you to help with the questions. Only ask for a further referral if you are not happy with what happens at the appointment.

I am so very sorry you have had to wait 18 months for an appointment. It's the pits when you are waiting and living with something that is impacting your day to day life badly, ( I've been there, so I do understand)but hopefully the appointment will go well

You can ask at reception and they may put a note on but for all you know the consultant could be on annual leave/sick/on call or they may have already picked out the patients they want to see in advance.

Secretary will likely tell you they can't guarantee you'll see the consultant either, but they would have been able to give you a bit more info eg 'not possible, Dr X isn't even in on this day' or 'yes that's fine Dr Y sees all new patients him/herself'.

Remember the reg's (and specialist nurses, for example) work under the consultant, if a consultant has a slight bit of doubt about a reg they would not be in their clinic treating their patients

Something else to be aware of - and of course this is not what always happens, depends on what you might have and how the team is set up - is that your initial appointment will be with a "junior" doctor, who should go through your history, be able to explain how they are going about your care, talk through options etc, and (crucially) commission relevant tests.

And then, once they have all that info (and possibly after a multi-disciplinary meeting if whatever's up straddles specialities), you are likely to get an appointment with a consultant to launch the actual treatment plan.

Another question worth asking is if they have a specialist nurse who you can contact if you have more questions that occur to you after the appointment.

MN quote, perfectly needed here:

Did you mean to be so rude?

Jeez. OP says she has PTSD and a life altering condition. What a nasty response.

HTH.

I didn’t mean to be rude, but I took offence at the implication junior doctors are substandard when they are not and can be actually better than those with more experiences. That is separate to OPs PTSD, which is obviously terrible and must be a really difficult thing to experience.