Is it possible to ask for a different consultant to be assigned to your case?

[emkana]

Ds's consultant is not being very helpful at all and I'm not happy (latest gem today: I ask about result of blood tests of cord blood taken straight after birth - letter about it in ds's file, because other doctor told me) - consultant says: "I'm not aware of any blood tests." WTF?
She hasn't even examined ds yet, the one appointment we did have she didn't show up...
I could go on. I want somebody else. Is it possible?

I work in NHS. In the hospital I work in, if a patient tells me they want to change consultant, I tell them it's an easy process. All you do is write to the Clinical Director at the hospital you are attending, stating you wish to change consultant. You don't even have to say why if you don't want to, although perhaps it might be a good idea to let them know why in your case.

I assume there is more than one consultant in this speciality at your hospital??

emkana
We changed our ds's consultant, but found out who we wanted to move to first.
Dh spoke to the new consultant, explaining why we wanted to move, and he (fortunately) had sympathy with our reasons.
We did have to get our GP to write to the new consultant asking him to take us on.
I think B'ham Children's Hospital are still sulking with us though - but I couldn't give a monkeys - has to be what's right for ds - as you well know!
Good luck - been wondering how you're doing

Agree with the moon but obv. write to the clinical director of paediatrics or whatever relevant specialty you want... (ie there is usually more than one clinical director, each heads a clinical directorate. There's usually one overall medical director for the whole trust).

Oh yes, sorry Edam.... I forgot that bit about speciality.

Alternatively, if you have a good GP (and having a good GP is pretty much the key to a good NHS experience IME) tell him/her about the problems and ask for a re-referral, either to a different hospital (might have to travel, though) or to a different specialist.

Thanks for your answers.

This is all such hard work.
I am actually seeing a specialist in Germany next week, we'll see what he has to say.

If he comes up with a diagnosis, what do I do then? Come back here and tell the consultant what the diagnosis is - and then?

the consultant in germany should keep the one in this country informed. You should tell the german one to write to your english one, otherwise your NHS records won't be up to date and accurate.

emkana- I too have been wondering how things were going for you. I am no expert in these things but from your OP it doesn't sound like you are being copied in on correspondence concerning you. I was recommended to ask for this, 1 big hospital locally does do it and the other doesn't. If you have letters concerning all tests it will make talking to the german consultant easier.
I have changed my own consultant very easily. I saw my normal one (nice but unimpressive) and asked her about someone else locally whose name is cited in a lot of research into my condition. She asked me if I wanted to see him for a second opinion which I did . (In fact I was happy to apy to see him privately if need be) she referred me on the NHS, I saw him 2 weeks later and he has been really really helpful so am transferring to him.
I hope that you can do the same as easily.

If you like and trust the German consultant, ask him/her who he/she would recommend you see in England. They all know each other, ime.

What about the nice consultant you saw antenatally? Could she not recommend you someone? How about your GP? Who is the recognised expert in that field? Have you done a search on Pubmed to see which names crop up in research articles?

I think it is incredibly important to find a consultant that you are happy with, as your whole experience of managing a condition depends on (a) getting the very best treatment and (b) being confident that you are getting the very best treatment. Even if you have to travel for an initial consultation, at least you would have an opinion that you have confidence in. From that point further treatment/appointments could be delegated to a centre nearer you if appropriate.

Would be a bit cautious about seeing several different consultants in parallel, though, particularly across two different health systems(ie. German and English), although I can see that you may feel happier discussing it with someone from your own native waters, as it were. It's just that if you have to deal with Sebastian's issues in England, then you need to find a system within the NHS that works for you, and the German system is very different, as you already know.

Fingers crossed for you.

You have every right to ask to see someone else.

Do some research on the consultants in the field you require though.

I know what you are saying, frogs, but I just want a diagnosis asap and it seems much more likely that I will get one quickly in Germany.
The consultant here obviously doesnt give a damn, really. Ds is okay atm, so she sees no need to do anything much. It seems that here it's more reactive than preventative. People in Germany were all flabberghasted that after the pregnancy I've had so little has been done so far to get to the bottom of ds's condition.
It's difficult to know who to get referred to in hte UK, because so far the only thing we know is that ds might have a skeletal dysplasia - but there are over 200 types and different people specialize in different ones. So the first thing is to know which skeletal dysplasia ds has... which they're not really bothered about here... hence my hope that the doctor in Germany will be able to tell me more. He specializes in skeletal dysplasias.

Well, fair enough. If the German consultant can tell you his opinion, he can then refer you to one of his colleagues in the UK. But don't underestimate the power of Uk-style 'under-managing' a medical condition, either. Whenever I go to the Dr in Germany (something I avoid like the plague if at all possible) they are always trying to persuade me to take some drug or course of treatment for my so-called conditions. They tend to get particularly exercised about my low blood pressure, and are horrified by the fact that I haven't seen a consultant for three years and am now on no medication for a condition that, according to the text books, is incurable and requires drugs to manage it. The fact that I am completely fine for all practical purposes and that I would have the good sense to pick up the phone to my erstwhile consultant if I felt a recurrence of symptoms seems to pass them by.

But it is very hard when you are starting out and trying to get a handle on unknown territory, so I absolutely understand your anxiety. Just be aware that you may not be able to get definitive answers, or that if you do, they may still not give you an accurate prediction of how the next few years will pan out.

Hugs.

Glad to hear you decided to go to Germany. IME if you come back with a diagnose and that diagnose is shown to the paediatrician you are immediately forwarded to a person who can follow up on what you have been told.

However there's a trick to it, you have to show the diagnose to someone who knows enough not to be intimidated by you having a second opinion. I have been told many stupid things by GPs and even junior doctors that I wouldn't like to mention but as soon it got to the paediatrician hands it all went perfectly, from what I have seen, the more knowlodgeable the doctor the more open he is to hear the opinion of another colleague.

Do you think I should inform the consultant here that I'm seeing somebody in Germany for a second opinion, or should I just tell them if/when I know more?

I didn't. And I think it was a good idea, I mentioned about tests and going private and I was told it was a waste of time and money and that they would do the testing as soon as a space was available. Well, DS got the "space" to have the tests 18m after we were refered, thankfully we were already following the other consultant advice. I really felt angry at the local consultant when he finally said " I have to conceed you were right all the time" Fine, thanks god we didn't follow your advice of waiting!

Don't know, emkana. If you're not happy with your UK consultant, then you're going to be looking for someone else anyway.

I still think you sound as if you need a good GP. I know that if you're used to having direct access to specialists, as in the German system, the GP system here can seem a bit superfluous. But if you get a good one, they can help you negotiate the whole minefield of specialists, refer you to good ones, re-refer you if it goes pear-shaped, and help you to interpret the consultant's pronouncements. Even a shoulder to cry on if you get really lucky. Honestly, it's made all the difference to me.

BTW if you ever want to CAT me to talk through the whole German-UK interface thing, do feel free. It is a tricky one, it really is.

chandra, for you!

frogs, thank you. It is frustrating, I'm still so used to the German way of doing things and find myself frequently baffled by how things are done here.

@robinpud Hi there, I just want to thank you for your post on this topic as it gave me the courage to act inspired by your experience. I wanted to be seen by a different consultant. I have been diagnosed with a condition that is uncommon and challenging to try successfully. I was in a right state as the consultant I was under actually made a "joke" about the disease being incurable (it isn't - although only about 20% do recover) and literally said "there's nothing I can offer you" when actually there are treatments worth trying. Being typically British my main worry was upsetting HIM! But after reading your post I made a guess at his email address - pretty easy to work out - and actually emailed him direct - a very carefully worded and conciliatory email putting emphasis on my mental heath needs and asked if I could get "another" opinion from Professor X who was one of the top dogs in the department. He replied almost immediately saying he thought that was a great idea and he would request it and I now have an appointment with Prof X in 3 days time!!!

Of course not all consultants are the same but I think in my case he maybe was more comfortable with the request coming from me rather than himself - that that was maybe easier for his ego somehow?

My dad is a retired clinician and when I told him he replied that of course consultants will agree to a "second opinion" request because once one has been made in writing they have "no where else to go" but comply. I see what he means and part of me even wishes I'd toned mine down a bit - but that's irrelevant - the important thing is I am seeing someone else which is what I desperately wanted.

I completely understand all the fear around making such a request but just urge people in our position to be brave, polite, non confrontational and hopefully have an easy, positive experience in the end as we did.

@emkana

I know what you are saying, frogs, but I just want a diagnosis asap and it seems much more likely that I will get one quickly in Germany. The consultant here obviously doesnt give a damn, really. Ds is okay atm, so she sees no need to do anything much. It seems that here it's more reactive than preventative. People in Germany were all flabberghasted that after the pregnancy I've had so little has been done so far to get to the bottom of ds's condition. It's difficult to know who to get referred to in hte UK, because so far the only thing we know is that ds might have a skeletal dysplasia - but there are over 200 types and different people specialize in different ones. So the first thing is to know which skeletal dysplasia ds has... which they're not really bothered about here... hence my hope that the doctor in Germany will be able to tell me more. He specializes in skeletal dysplasias.

Go to Leicester Royal Infirmary if you can. Don’t want to say too much here as it’s outing but they were really good in my friend’s experience. Her son has SD.

This thread is from 2006.