Private healthcare novice - is this normal?

[SeagullGirl]

I have a bunion developing on one foot - previously causing no problems and GP sent me away with no real advice. Situation has developed and I now have joint pain as well and want to all I can to prevent progression. I phoned health insurance to see if covered for this. They said no, but referred me to an occupational health service which is included. After discussion with their nurse she referred me to a SURGEON at a local Nuffield hospital. I had expected a podiatrist. I looked him up and he deals with lower leg issues but not feet specifically.
Do I go ahead with the appointment and he can me refer me on if necessary. Or is this a colossal waste of everyone's time (and my excess)?
Can't help feeling i'm going to be embarrassed if i turn up with my slightly dodgy (but still perfectly serviceable) toe...

TL;DR is it normal on private healthcare to be referred straight to a consultant surgeon? Or is everyone going to laugh at me? I realise that bunion surgery is a thing, but i don't think I'm at that stage yet.

I went to gp about my hernia. He referred me to nearby hospital. When I got letter it said I will see Mr Smith. I expected him to mean a nurse. Well I met consultant surgeon. I was surprised and later on found out that surgeons tend to use Mr Miss etc instead of Dr.

Well anyway I went from gp straight to see surgeon at NHS.

Yes I get you, but presumably the gp thought you needed surgery and referred? In my case nobody has suggested I need surgery and it hasn't been mentioned by me or by anyone else. The person who referred me was a hcp but over the phone. I said I just wanted advice to prevent things getting worse.

Yeah now i reflect on it i think i am going to have to do that.

Really sensible to see an orthopaedic surgeon for what is a joint problem - ds is going to see an orthopod for his bunions (which are fairly extreme and I believe are causing problems further up the leg) via the NHS. If podiatry/orthoses are needed then the surgeon can refer to them. It would be sensible for the surgeon to take baseline X-rays to refer to in the future if they get worse.

Oh OK that makes me feel a bit better. Sorry about your DS. I've always had wonky feet but they've never caused problems before. I have also always had v sensible footwear so I'm feeling a bit miffed by all the references to high-heels and pointy shoes being a probable cause.

Normal for private healthcare, insurers expect 1st attendance to be with a consultant , consultant then refers on to others

You probably could just ask which local podiatrists are covered and self refer. Bunion surgery is no longer as readily recommended so a surgeon won't necessarily go ahead.

Hotbot - great good to know.
Navy - don't worry I figured as much
LIZS - I don't think there was a way I could do that without the referral from occupational health and they've sent me to the surgeon. I understand about the surgery and am hoping now that I'll get a further referral.

I've recently had surgery for an arthritic big toe and read up on subject of big toes beforehand.

Bunions are quite often inherited and not just caused by poor footwear choices.

When I went to a GP about my painful big I had an X-ray and was then sent to a podiatrist. Only went once as he said I had arthritis so referred me on to the hospital.

You are not wasting anyone's time OP. Foot problems if left untreated can lead on to knee, hip and back problems because of the changes in the way you walk to avoid the toe pain. Also we propel ourselves forward from the heel through to the big toe joint. That's why surgery is needed if other solutions like orthotics or steroid injections don't work.

Bunions seem pretty genetic to me. My family look reasonably normal from the ankles up but my mother's side in particular look like rail station signs with our shoes off. We are all fans of Hotter shoes and similar fashion atrocities, don't know if this is cause or effect.

Normal for private healthcare, insurers expect 1st attendance to be with a consultant , consultant then refers on to others

I don't agree with this.
Normal practise is for GP to take a look and then refer to a consultant OF YOUR CHOICE. You are paying if it's private (through insurance.) There is no point wasting time to see 'a consultant' other than the right one for your condition.
We've had private insurance for almost 35 years. We usually do our research on who we'd like to see for the condition then go to GP and ask for a referral letter- having first checked with the insurers that it is a condition they would cover.

I don't understand an insurance company NOT covering bunion surgery. If it's cosmetic and not painful, that's fair enough, but if it's painful and stopping someone being mobile, that is different.

The way I understand it is that:
The policy does not normally cover musculoskeletal disorders directly, but refers them to a separate company who are primarily occupational health, getting people back to work etc. This is an add on to the normal level of cover.
The insurance company referred me to the occupational health company, but after a phone consultation they deemed that a referral was required. I presume the insurers use the occ health service as a filter/middle-man to determine the necessity of further treatment (or whether other sorts of support are more appropriate).
Hence I couldn't get referred in the normal way straight from the GP. However, the occ health lady did ask me if I had anyone in mind to see. As I wasn't expecting it, I had no idea, so I went for the closest hospital and she found me this particular guy. Looking at it further, there may be someone better suited at the next closest hospital.

Maybe I should be changing my referral? Or is it too late at this point? (I haven't yet made any appointments).

I'd not call bunions muscular skeletal. That tends to be things like back pain so insurers are not covering for things that are chronic. Did your GP decide they were muscular skeletal?

DH has had 2 operations on his big toes (arthritic wear and tear.) Originally his GP sent him packing with pain killers. But it was getting to the point where normal walking was an issue, never mind running etc to keep fit. He asked for a referral to a private foot surgeon and the ops were done through insurance without question.

You are the customer. If you think there is another dr who is better at bunions, cancel the appt and make another one. With our insurance, we choose who we want to see, phone their offices and make the appts. This is normal practise.

ps I think- re-reading your first post- the insurance company may have thought your request for bunions was that they were cosmetic rather than affecting your movement and day to day life. It may have been better to have avoided 'diagnosing' yourself and instead saying you had an issue with your toe joint/ feet and needed to see someone.

Oh- and you need to check that whoever you choose to see is on the 'list' of drs the insurance company funds. Some policies have a cap on fees and if a dr is very expensive, you may have to top up the cost. (This is rare but worth checking.)

OK thanks. I basically have very little understanding from either an NHS or private point of view having never needed anything other than GPs and maternity services to date.

I may just do a bit more research on doctors and get back in touch with the named contact at the occ health company before proceeding. The bunion was diagnosed by the GP. The joint pain is new, and I was clear about this on the phone. I am concerned that it is the start of athritis in that joint.

I'll be watching this post because I have bunions and my joint is now hurting, well, its been hurting for about 2 years but had other more impt health issues to address. I'm getting xrays of my feet done first.

I've sent in a request to see if I can change my referral to a more appropriate surgeon (specialises in feet). That at least will make me feel like I'm heading in the right direction