Referral to Consultant: Can we ask for copy of ... - Thyroid UK

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Referral to Consultant: Can we ask for copy of referral letter? Is this a wise move?

JMN2017 profile image
41 Replies

I've decided to ask GP for '2nd opinion' (presumably Endo, but also possible B12 deficiency) because, just a few days ago, he told me that, as all my test results were within normal range, he can't help me anymore.

So that I can be aware of what info the GP has given in the referral, am I entitled to a copy of this referral, please?

Having asked this, I'm wondering if this is a wise move. Will it antagonise the GP further, to my further disadvantage? Maybe it would be better to ask 'specialist' if I could see the referral letter at the appt?

Hopefully, one of you will be able to advise me ;) Many thanks

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JMN2017
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SeasideSusie profile image
SeasideSusieRemembering

JMN2017 Why not ask at reception for a copy and see what they say?

I got a copy of a referral to a consultant (not thyroid related) because the wait for the NHS appointment was so long (in fact, 12 months on and I'm still waiting) and I was so unwell that I decided to see him privately. I asked his secretary if I needed another referral or would the one for the NHS request do. I was told to just take a copy of the NHS one along. So I asked at the surgery and it was printed out for me. However, it was not a letter, it was a form where relevant parts were filled in and just the briefest details in the box for why I was being referred. Not sure if that's how it's done everywhere now (this is Wales).

Kitten1978 profile image
Kitten1978

Why don't you ask the receptionist for a copy of the referral? If she is "funny" about it you could write to the practice manager officially requesting the copy. It's a good practice to send a copy of the referral letter to patients but it rarely happens ;(

JMN2017 profile image
JMN2017

SeasideSusie and Kitten1978

Many thanks for both your replies. I didn't think of requesting a copy via reception. That's absolutely brilliant :) :) :)

Yes, I can ask at reception once the referral has been sent so that shouldn't antagonise the GP particularly and, yes, if the wait is too long, it also gives me the option to seek a private consultation which, hopefully, could be followed up as NHS, seeing as already referred :)

So so so many thanks. :)

Kitten1978 profile image
Kitten1978 in reply to JMN2017

You are welcome. If a doc ever has a problem with a patient obtaining copies of any letters it's because they don't have clear conscience. Docs letters' contains all sorts of mistakes from spelling mistakes, grammar mistakes, innuendos, distortions and statements which are simply not true. Mistakes aren't usually an expression of bad will but they can be harmful. If we were more proactive in asking for copies of their letters and our medical files, they would be more careful in writing them.

JGBH profile image
JGBH in reply to Kitten1978

Hi Kitten1978,

Indeed patients need to be more proactive and show GPs we are refusing to be fobbed off any longer. One should ask for copy of referral letter. If they look uneasy/cross, or refuse then you can be sure they have "played dirty"! They are disgusting... and it makes me very angry indeed. One wonders why they became doctors in the first place!! Money and status more than likely. There might be the odd genuine and caring GP.... but where is he/she?

I recently went for a private appointment and collected a referral letter from reception. Naturally I read the letter and was disgusted to see how the GP has "rewritten" my medical history, playing everything down, and trying to "plant seeds" in consultant's mind, so that the consultant would not take me and my problems seriously. So I decided NOT to take letter to the consultant. He has taken me seriously and follow up investigations were arranged. We must show the GPs we are not prepared to trust them blindly and treat them like "gods"... they often think they are!

Kitten1978 profile image
Kitten1978 in reply to JGBH

I absolutely agree. It's not "just" the GPs, specialist doctors including endos are equally bad.

It makes you wonder: Why they actually do that? What's the point? It's unethical, for starters.

JMN2017 profile image
JMN2017

Sorry, SimonA87 but I can't agree with you :( As well as being a patient, I have also been a Ward Sister, and worked in clinic, so I've both seen and experienced it!

The doctor can most certainly be 'prejudiced' by the referral letter, however carefully the GP chooses his words, or because of the choice of words!

So, knowing what is in the referral can be useful when it comes to preparing for the appt. I have the advantage of being very much underestimated ... ;) Unfortunately, it still doesn't always work ;)

So, just have to keep trying. Eventually, I might just win the battle ;) Have to keep believing this and keep some hope, eh? ;)

SimonA87 profile image
SimonA87 in reply to JMN2017

Good luck to you :)

Kitten1978 profile image
Kitten1978 in reply to JMN2017

JMN2017,

I couldn't agree more!

JGBH profile image
JGBH in reply to JMN2017

JMN2017, absolutely right! So glad some of us are aware of what is happening. It is unbelievable to see how GPs dislike patients and are not really prepared to do the job they were trained for but nevertheless "take the money"! I wonder whether they have been trained to help patients or just to ignore them,sometimes.

Manz123 profile image
Manz123

I have signed up to get electronic access to my records via patient emis or something like that. Not sure if all surgeries do it. I now have access to all the letters sent to and from gp, blood tests etc whenever I like. It only shows my records from when I became registered for access though, so nothing historic.

I think being obstructive and difficult is part if the requirement for the receptionists at my gps. Now I can bypass all that!

JMN2017 profile image
JMN2017 in reply to Manz123

Manz123

To be honest, I hadn't thought of being able to see the referral via elrctronic access. Thanks so much for pointing that out. :)

I do have electronic access but didn't appreciate referral letters, and communications between hospital would be on there. I order meds, see blood results and surgery attendances but haven't been referred, or had any hospital appts since gaining access. That will be useful then, eh? :)

Fortunately, the receptionists at my surgery are actually very helpful, I'm pleased to say :)

Manz123 profile image
Manz123 in reply to JMN2017

All my referral letters are on there. Also, the letters from gastro to endo were cc'd to my gp so I can also view them. I had to ring them to ask them to enable access to test results as that didn't get set up automatically.

Good luck with it :)

Gcart profile image
Gcart

"I think this patient has been reading up on symptoms " caught sight off referral letter from GP on consultants desk.

Turned out it was bowel cancer !

Trust no one 😐

Hillwoman profile image
Hillwoman in reply to Gcart

I hope you're making progress in your recovery Gcart .

I've seen similar remarks on my health records, though gaining access to them is still a struggle. One GP wrote on an urgent referral for breast cancer, "This patient has read articles on this subject. I thought I should warn you of her attitude."

Edit: thankfully, my test results were negative.

JMN2017 profile image
JMN2017 in reply to Hillwoman

Hillwoman

Pleased you didn't have cancer but you will have gone through so much stress until you got confirmation it wasn't cancer.

I consider what your GP wrote in the referral was totally out of order. Hopefully, the consultant/doctor you saw was not too chuffed with your GPs attitude. Would be even more out of order if the consultant took note of this comment, before seeing you and making up his own mind :)

Some of these doctors just have no interpersonal skills, nor idea of how other people can see through this sort of attitude!!! No doubt, HE is the one with the attitude, not you ;)

Hillwoman profile image
Hillwoman in reply to JMN2017

Thank you. :-) I've been through several such procedures over the years (thankfully, always negative results), and they are always stressful in themselves. You are quite right - a certain kind of attitude from health professionals just adds to the patient's burden.

These sorts of comments litter my health records and referrals. Sometimes the consultant reads the GP comments, and inevitably it adversely affects their conduct towards me. If they start by asking me for my history without looking at the letter, my stress levels drop immediately!

Dreamer12 profile image
Dreamer12 in reply to Hillwoman

Hi Hillwoman

What a horrible attitude re the remarks your doctor made, but so glad your results were negative. X

Hillwoman profile image
Hillwoman in reply to Dreamer12

Thank you. :-)

Kitten1978 profile image
Kitten1978 in reply to Hillwoman

I can see only two ethically justifiable reasons why one healthcare professional would want to warn another healthcare professional about a patient:

- patient has a history of physical violence towards NHS staff,

- patient has previously has made false allegations of sexual abuse. Therefore they need to be seen in a presence of a female chaperone.

Anything else is unethical.

Hillwoman profile image
Hillwoman in reply to Kitten1978

Very interesting, and your assessment is spot on! I've always been polite and calm with health professionals (I take my husband along for feedback), but I've seen myself described in my records as 'aggressive', 'demanding', 'unreasonable', 'hysterical' (that old chestnut), 'depressed', 'exaggerates her symptoms'' and so on.

These are all responses to fairly innocuous questions from me, or my persistence in trying to improve my situation, or my polite refusal to go along with something I felt was not in my best interests. This profession is completely antediluvian in its attitude to the people it claims to serve.

Kitten1978 profile image
Kitten1978 in reply to Hillwoman

It's not only the doctors, I'm afraid. I've seen other healthcare professionals e.g. OTs, physios, psychologists, nurses being judgmental and dismissive towards patients' symptoms ;( It usually stems from their own insecurity and lack of confidence (=being easily threatened), lack of knowledge and experience, which leads to being overwhelmed by what the patient is presenting with. The end result is: "I cannot cope, I don't know what to do, my heart sinks, can somebody please get them out of my clinic...etc."

Hillwoman profile image
Hillwoman in reply to Kitten1978

I agree. I think the way the various health professions are trained, and then not properly supported in their working lives, does not really enable them to help patients cope with the complexities of real-life conditions.

I've also observed that the health professions actually attract certain subsets of personalities, particularly those with a need to control others, or those who may have experienced trauma, and who have a vengeful need to 'get back' at people in some way. By the nature of their circumstances, patients are peculiarly vulnerable to bullying and other poor behaviours.

Kitten1978 profile image
Kitten1978 in reply to Gcart

An intelligent patient is a THREAT.

JMN2017 profile image
JMN2017 in reply to Kitten1978

Yes, and they can't deal with it.

When I was nursing, I came across several 'difficult' patients. One patient even had a long entry in his notes written by the consultant, as clearly they felt they could expect a nasty complaint. I came back from holiday (was Ward Sister) and was 'warned' about this patient.

So, after going round to see ALL the patients (all 30 of them), as was my habit, deliberately left this chap till last. Introduced myself (with smile on my face etc), pulled up a chair and explained that I understood he wasn't happy in hospital, and that I'd like to hear what his problems were so we could, hopefully, sort it all out.

Ha, within 1/2 hr, he was a happy chappy! No one had bothered to find out why he was so unhappy or to try understand his predicament etc.

Three main issues -

1) Not understanding why he needed to stay in hospital, on traction, rather than to have POP and go home - worried about wife (both very elderly) OK, explained, in terms he could understand, why his injury required traction and not POP.

2) Missing his new wife desperately, worried about her on her own etc. Can she come to the ward in morning and help with his care? Sorted!!!

3) Always had hot milk at coffee time and bedtime - not available on drinks trolley! Asked him if wife would bring in hot milk in flask, take 2nd (empty) flask home to refill and bring back next day. Temporary measure! Phoned Catering Manager, told him patient wanted hot milk, as was his habit, and that I'd arranged that wife would bring in flasks!! Ha! I knew he wouldn't like that so hot milk provided as from that evening :) Sorted!

He was then a changed person, consultant commented on change of attitude the next day but unfortunately I wasn't there to hear this and never got the credit for it ;)

Excellent example of good communication!!! Why can't others 'communicate' too?

Patients who show some intelligence, and ask awkward (sensible) questions are definitely a threat and to be avoided at all costs. Interestingly, I never needed to avoid these patients, probably because I could understand why they asked such questions - often were other 'professionals', ie teachers, solicitors, people used to having some authority etc. Yes, definitely, staff can't deal with - feel too uncomfortable and don't encourage them to explain what the concerns are. It would make their (staff) lives so much easier if they 'communicated' and 'understood' ;)

Oops! Sorry for long post ;)

Kitten1978 profile image
Kitten1978 in reply to JMN2017

JMN2017,

The fact that you no longer work as a nurse is a sad loss for the NHS!

Often the system is to blame: I have seen people getting so burnout and exhausted that they had no energy to care about their patients ;( It happens at all steps of the NHS food chain: from a nursing assistant to a consultant or a manager. The NHS is very uncaring towards its own staff and patients end up at the receiving end of this ;( I cannot see more UNhealthy profession than a healthcare profession.

JMN2017 profile image
JMN2017 in reply to Kitten1978

Hi Kitten1978

Unfortunately, you're so right. The NHS has changed so much since I first started working within this organisation.

:(

MollyStark profile image
MollyStark in reply to Kitten1978

Absolutely kitten! My husband was listening to a radio interview with a couple of doctors recounting their experience of working in the nhs over the years. Apparently, the intelligent, older patient is guaranteed to make younger doctors feel intimidated and nervous.

Kitten1978 profile image
Kitten1978 in reply to MollyStark

Funny enough: intelligent, outspoken patients could be potentially easier to work with: they know what they want, they might have already read about the symptoms and have an idea what might be wrong, they are motivated to take responsibility e.g. regarding life changes, they plan and act on their plans, the can literally tell a healthcare professional what they need. If docs could actually work with their patients as partners instead of locking themselves in their "I'm an expert" shell, their lives would be potentially easier.

Gcart profile image
Gcart

Good for you Hillwomen

Yes I'm good now that was 8 yrs ago . But I'll tell you what it leaves a deep scar apart from / and the one on my abdomen. 😐

On reflection , the emotional one runs deeper as a result of poor treatment . ☹️

Hillwoman profile image
Hillwoman in reply to Gcart

Yes, I think you're right, but I'm so sorry to hear your NHS treatment affected you this way.

Glad to hear you made a good recovery. :-)

Marz profile image
Marz in reply to Gcart

Gcart - around 50 years ago I was told the painful swellings in my shin bones could well be an allergy to cabbage 😊Later the rectal bleeding was because I didn't know the difference between my back passage and my front 😴 In 1973 i was in hospital for over 22 weeks - 5 surgical interventions - it was gut TB AND Crohns ..... and so lfe goes on .....

I have learnt quite a lot in the intervening years and have reached 70 in reasonable health 😎 - mostly by reading and learning .....

PS My scars are a work of art and the internal amendments confuse even the best ☺ I was alnost tempted to enter the pics of a recent colonoscopy into an art exhibition ..... !!

Gcart profile image
Gcart

Lets all hope that we get the appropriate treatment for our health problems . Long live the internet and the ability to help each other and ourselves 😘

ellj profile image
ellj

Totally not thyroid related but I still smile when I recall a letter written about my husband by GP.

It began " this very peculiar gentleman " I was not smiling at the time !

Dread to think what has been said about me in referral letters as I have always been pretty proactive in voicing my opinions....Until recently when I find the right has gone out of me, I cannot face it anymore and would probably have rolled over and faded away were it not for the lovely peeps on HU.

ELL

Jeppy profile image
Jeppy

Tagging on, I was left permanently numbed after wisdom tooth extraction, a lovely receptionist may have been too helpful, as when I asked for my notes to read, I also got sent the form filled in by the dental consultant who took out the tooth,

It read, "this woman is lying as she has all sensations!????!!" This was 2005 and I'm biting my numb lip at this moment as writing. . I was livid and a lot of respect lost

( they say to allow 3 years for sensation to return but now see this is the same time scale you have to complain for possible compo .... )

JMN2017 profile image
JMN2017 in reply to Jeppy

Oh dear!!! So sorry to hear this. Interesting to hear the '3-yr' healing time, eh? Yes, you do have to log intent to put in claim before the three years. All very tricky and the professionals don't want you to know the finer details / implications.

Did you send a complaint, though, once you read what had been written? The consultant, nor anybody, has the right to make such a statement!

No doubt your GP didn't sympathise with you either :(

We're only 'patients', though, so clearly just an inconvenience, with no intelligence, no rights, no respect ... ;)

{{{Hugs}}}

Jeppy profile image
Jeppy in reply to JMN2017

👍exactly haha. I was told at the end of the day of the tiny compensation with lost sensation and my feelings were so raw I couldn't bother,

to be honest i found it devasting, I wouldn't eat out for two years as took the brain this time to get used to it! It felt huge like the hole does when you loose a tooth! ( dribbled a bit to be blunt). Like when you have anaesthetic injection (but was permanent )

Anyway past now, just really insulting to be treated this way

MollyStark profile image
MollyStark

Why are so many of us concerned at antagonising gp's and consultants? I have had the same concerns in the past but try to focus on the fact that it's my health and unless I voice my concerns the drs are not going to act. They are just people, usually the only reason they went into medicine is because they had the financial background to do so but they fail to recognise or acknowledge that most 'ordinary' people have the same intelligence to understand everything they do. As someone who is not outspoken, very shy and suffers from anxiety, every drs appointment is a nerve wracking experience but above everything I try to focus on my health and ignore their arrogance and dismissive attitude.

Many years ago when i was in my early 20s, i went to an nhs emergency dentist due to bad toothache for several days over a bank holiday. He put an injection right into an abscess, the pain was excruciating and I cried. He called me a baby for crying. Thankfully, my boyfriend was with me and told him to stop and took me out of there. I was so weak and in such pain I couldn't have fought the dentist and he was about to extract 4 teeth (completely unnecessarily - thereafter he was reported by my usual dentist for his actions.) I don't think times have changed much and we still need to 'fight' the medical fraternity. It is quite disheartening really - but...thank goodness for the internet with its access to informaton - and to my then boyfriend who is now my husband and still has the same strength to stand up for himself and me when necessary.

JMN2017 profile image
JMN2017

Sorry to hear about your dreadful experience. :(

JGBH profile image
JGBH

Hi Simon,

Disagree with you, sorry. Often a consultant will be influenced by what an uncaring GP who is not doing his/her job properly and who will have written about a patient. More so especially when the medical history has been "rewritten" incorrectly by GP as it has happened to me. It's a shameful battlefield. Patients need to be aware and proactive.

Jeppy profile image
Jeppy

Yes awful

If you were referring to my experience molly I had a load of other things at the same time and yes on my own. It does make a difference when you have a supporter I'm sure, sometimes in life there is only so much you can deal with on your own and I knew deep down it would only make me feel more wretched inside to try and battle with nhs dentist, at the hospital, they have their closed rank thing going on, for sure (I was also in anxiety attacks at that time. Holding down a job, supporting my daughter and loosing my mum )

However I Diid write to the chief three years later when I came across the paper work again in my box, and emphatically told him I was STILL numb in lip and chin and sent a copy of the dentist remarks with disgust ..... and I never heard back, I then became angry which is a horrid emotion so wish I hadn't bothered

Anyway yes I do agree that if a doctor is worth their salt they will absolutely be happy to explain, and if you ask to see a specialist I have found they are even more inclined to explain further and support you best they can, Iv just been through 'this myself, one was arrogant and phoned me at home to say to just trust him, so I haven't been back to him obviously, this is not the kind of gp you need for sure

Bring the best out in them is quite a good way forward 👍

I hope you don't mind me mentioning here that the info is amazing that some of you give, I feel though it's not in best interests to put tings about dying etc , Some of us have enough irrational fear without that on top (, I hardly slept last night,). please remember there are all types of personalities reading here especially newbies can feel overfaced a bit )with the realisations of it all )

Best wishes px

,

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