Update to last post.: As suggested I wrote a... - Thyroid UK

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Update to last post.

PurpleOliver profile image
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As suggested I wrote a request, via Patches, asking for a Gp to refer me to a private endo. I got an appointment for Today to speak to a clincian, who turned out to be a paramedic. He informed me that 'They' do not write referrals to private endos. I would need to approach one myself and if He/She wanted to know anything about my history then he/she would have to contact the health centre for them to provide what they require. The paramedic said that he could book me in on Tuesday for a full panel blood test re thyroid, but I informed him that Im already booked in on the 3rd April for a rhuematology test. He said he would add to that one, then when he looked, the Dr had already put the thyroid request on there! Something he didnt inform me about. I Did explain about my private blood test Id had done, showing that my t3 was low, and that the dr didnt even look at the results, but he didnt seem interested. I also said that my stomach has been feeling bloated and he said that that sounds more like the bowel, so has added a stool test to my blood request form too. Probably thinks Im constipated!! Only thing Is, its the wrong end!

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PurpleOliver profile image
PurpleOliver
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HandS profile image
HandS

I have never heard of a GP refusing to provide a referral for a private Consultant before. You could contact your chosen Consultant’s secretary and ask if they have a process in place for such circumstances.

I am so sorry you were treated like this.

helvella profile image
helvellaAdministrator in reply toHandS

But it isn't a GP - rather a paramedic.

I could be entirely wrong, but I'm wondering if a paramedic can't refer? (Though on what basis, I don't know. Could just be 'professional etiquette'.)

HandS profile image
HandS in reply tohelvella

Good point - I read it as the Paramedic advising PurpleOliver that the doctors at that Practice - i.e. ‘they’ had a policy of refusing to write private referrals and only providing info on request from a Consultant.

As is often the case when talking to anyone in public services, it is necessary to establish who you are talking to, what their role and remit is, and who they are qualified/authorised to speak on behalf of.

And then query what you are being told.

in reply tohelvella

The pros and cons of Paramedics in General Practice

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PurpleOliver profile image
PurpleOliver in reply tohelvella

Maybe. But I wasnt asking Him to refer me, just to pass the message on to a Gp who could. He was quite willing to read out to me what tests were being done, so he tried to help me out a bit, I suppose.

PurpleOliver profile image
PurpleOliver in reply toHandS

Thank you. Maybe it was because I mentioned a private consultant referral. Although I did ask to be referred to an Endo while I was face to face with him, but on my request form I asked for a private referral letter. He looked fedup when he opened his dokr to let me in, so I knew then it wasnt going to be positive. He Has ordered a full blood and thyroid test, as well as ones for reumatology so its something I suppose.

Batty1 profile image
Batty1

This paramedic is skilled in emergency medical assessment not thyroid issues and I would imagine he would be better suited for Emergency room medicine not GP office … just my opinion.

in reply toBatty1

From what I’ve seen first hand recently everyone and their dog is said to be skilled in thyroid issues - including the GP surgery’s Clinical Pharmacist, Paramedic and even some receptionists. No particular evidence of much skill among many GPs though

mrskiki profile image
mrskiki in reply toBatty1

Our GP surgery is down to single partner and is mainly staffed by nurses and paramedics and the odd locum, Yet the ones in the next catchment areas have about 6 partners plus the nurses and additional GPs. It does make me wonder if it’s about profit ….

in reply tomrskiki

It’s about something …. but certainly not patients.

Just come out of hospital and I’m afraid it’s the same there.

PurpleOliver profile image
PurpleOliver in reply toBatty1

I must admit Imwas surprised when he said he was a paramedic. Thought I might be talking to a nurse practitioner at the very least. He sounded as though he was 'armed' for talking to me re my request letter, so must have been prompted by someone in authority, maybe.

Wua13262348 profile image
Wua13262348

I think this must be common practise, as they just don't have time anymore to say anything in a referral letter other than "please see this patient," and provide copies of letters in your records. The reason the endo wants the G.P. referral is for facts, test results and information which a patient isn't expected to be able to provide. I made enquiries with the secretary of a private Endo this time last year. She said a G.P. referral was essential and THAT THE ENDO EXPECTED ALL PERTINENT INFORMATION TO HAVE BEEN PROVIDED BEFORE THE ACTUAL APPOINTMENT. This must be because what the paramedic said about wanting the private endo to ask for information , is exactly what the Endo must be encountering , and is the opposite of what he requires. She quoted a price and said if he had to read more than 6 pages it would be more. I decided that I really needed to do a lot more private thyroid bloods over the course of the next year so that he would be able to see what was happening with TSH, FT4 and FT3 over a decent period of time, whilst on levo T4 , to be able to judge if T3 needed, if T4 didn't do the trick.

Fast forward to this week, and I decided the time is right to be referred. I typed up 14 pages for the Endo of genetic results , blood test results and patient history. I phoned the G.P. and the receptionist asked what I needed an appointment for. I said a private referral to a pituitary specialist, and she said she would need to ask someone if I could have an appointment, and since she didn't know what it was , I spelt it for her. She consulted someone, and I was told I was to self refer. I told her that I couldn't self refer as the specialist has stipulated a G.P. referral is essential. I admitted then that it was an Endo. I thought if I said it was for something they had never heard of I would have more chance of getting past reception. I said a phone appointment was fine. When I spoke to the G.P. I was again told to self refer. I said that he only accepts G.P. referrals. It was no problem. Perfectly willing to refer when I explained why and I was asked what I wanted her to say. I gave her a sentence to quote, said I realise my Health Board is anti T3 ,and that I was seeking expert opinion from someone highly respected, internationally , who , if he said I needed T3, would be beyond reproach. If he says it's needed, then it is. His reputation is such that his opinion would eclipse that of the NHS Endo. I said that it would only be necessary for her to include anything of note, that I knew nothing about, since I already had a detailed letter written with extensive private blood tests over a period of time. She was perfectly willing to do this.

I have no idea what 18 pages will cost for him to read, but I have done extensive testing, have been ill for 37 years, and I've done my best to give him a clear picture of the journey. I don't care what he charges me any more, as long as he reads it, and gives me his opinion.

Unless the private endo you want to see stipulates he needs a referral, you will be expected to self refer. To do this you'll need to request your medical records for any information you feel that you need. That will be work for the reception staff, but cuts down work for the G.P., although usually a G.P. will review it to see if they want to with hold records.

I now know what was said to my G.P. about my one and only NHS Endo appointment as I have a copy of the letter provided to accompany my referral. It is very illuminating, and not in a good way. That's a story in itself.

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