GP's Reaction to me asking for a referral...

Post Reply New Topic

I tried my GP as well and she just laughed and told me I worry too much. She's old fashioned and doesn't believe in these things much. That's OK. I'll still trust her for traditional illnesses that pills can fix.

Now I'm going to get private diagnosis. Most people who know me well told me they're quite certain.

finding good health care is hard anywhere, and I hear the same things in Australia too. But I do have choice to a very large degree that I do not think is really possible in the UK or the US. The US is all about insurance and nothing else, and my understanding of the UK is that you are to see a GP in the area where you live, etc.

I can see any GP anywhere. Yes they refer to certain professioanls, but I can choose the one they refer too. Hence my current psychiatrist I found and went and saw the GP that I liked and was not close to where I lived and got a referal to her!! It allows the GP's to know professionals and choose the ones that they like, and pick and choose them for different patients. Some psychiatirst might be good for this, some for that, etc. GP's know them, we get total choice and I can travel interstate to see a GP of my choice if I wanted to. When I moved to my current area I was maintaining some contact with a GP 2 hours travel away, until I found one that I liked and when I got a suggestion, my former one rang them up first, spoke to them first, so they did get to know me and not just through medical records.

There are ways to have a public system that allows choice, it does not have to be one or the other, which is very much how it is in the UK or the US. The US you take total responsibility for everything and that is not always good, but are also totally controlled by the private health fund and in the UK the doctor you are deemed to see, simply by where you live decides who if anyone you can see. That does not mean our health system is not stuffed too and the waiting lists for public health care in a hospital are worse than you can possibly imagine. Need a hip replacement, get put on a waiting list for 3 years!! !! But in terms of day to day care and choice of people to see, we do have that. Hence I can get the Autism Society to refer me to someone and I can see them when ANY GP refers me!! !

The government here funds a certain amount of medical costs per session, etc, some things they have limits on the number of sessions per year, etc. Very few doctors only accept the government funded amount, but some do, and even if they don't they will for some people. I currently travel 2.5 hours each way for a psychiatrist and would not change her for a second. I have a psychologist locally who is brillant, but am limited in what the government will fund with her, but I have worked out a plan between the two of us of what I can afford, etc. Finding her as not been easy, and the answer does lie in screening them first. Any that are not willing to talk on the phone for 5 minutes to answer a few questions are not worth going near. Any that say they can treat anything at all, that have receptionists and the like who say they can treat anything is also really wrong. I would also not assume that child abuse victims are much better off, as most claiming to work in that field, know so little about it, and simply say it as it is a popular catch phrase.

When I moved to my current area I did struggle to find a GP, but I now have a brilliant one who really does get all the issues, etc. I found her through of all places rape crisis centres. While a totally seperate issue the idea was to find one who could consider that emotional issues exist, that people need to be treated with respect, etc. I have since discovered that she has many patients on the spectrum, knew of other resources and the like.

The other big reality is that none of my three primary treatment providers, psychaitrist, pscyhologist and GP advertise, and in some cases are not even listed in the phone books. They operate purely on word of mouth, and any really good professional often does. I did find an occupational therapist who specialises in Autism Spectrum Disorders through the Occupational Therapy Association of Asstralia. They have a list of accredited ASD OT's and so I contacted one, spoke to her on the phone, and gave her a go. She acknowledged up front that she had not worked with Adults, but she did regularly work with adolescents with AS and not just low functioning preschoolers with autism and I could not have been more impressed if I tried, and am continuing to have some contact with her.

My GP does not charge me over the government amount, but that is not something she does for others, or did for me initially. My psychiatrist is the same, as is my psychologist. But in order to work out affordable fee schedules I had to find ones I could work with first, establish a working relationship with them, and then come up with something that was reasonable for both of us. I cannot expect them to see me for $5 per session, etc.

Finding good professional support is hard, there is no doubt about that, and I have been in that position and am lucky that I have more choice in terms of payment than you do in other countries, but to say it is not possible is wrong. These people do exist, they are just hard to find, incredibly hard to find.

Look at the professional associations of the specialty, not just registration boards, they often have lists of professionals, ask autism associations for referrals, early intervention services, parents with chilren on the spectrum, etc, etc. Even if you find one who will not take your insurance, ask them for referrals, any decent professional knows other professionals in their field and should be willing to work to help anyone, even if it does not directly benefit them. If I go into a shop and they do not have what a want, but suggest a place that may I think positively of them, talk about them to others and are more likely to consider going back there again. A person may not take my insurance, but if they are willing to give me a few names and phone numbers I am more likely to recommend them to others who do have insurance that they take. And if the professionals they send me to know how I found them, then they will do likewise. Just becasue they do not treat adults, does not mean they do not know someone who would, nor does it mean they could not do it. I may be 37, but for me someone who treats a 16 year old with AS was worth trying, and is more relevant than a person who only treats low functioning autism in preschoolers.

The other reality is that in many cases it is not so much experience as being willing to learn. I had one who went off to professional development, read books, etc, to try and understand me more. She was simply willing to think outside the square, to not say that all people with this disorder need this, etc. And the fact is we are all different, what helps me will not necessarily help you, and so what I look for is one who is open to variety, who does not claim to know everything, does not have one pet therapy, etc. In fact when looking for psychologists the first question I ask is what types of therapy do you use, if they list names of say CBT or the like, then I say "no thanks". Sure CBT has helped me, but what I want and need is someone who is eclectic who treats all of me, and not just my negative thoughts per say. No single therapy can treat everything and if someone says it does, then I look elsewhere, as to me it means they are not open, they need me to fit a mold, as opposed to them fitting me, etc.

And I think I'll keep my free healthcare.
A swift consultation (heh) with Google revealed that in 2005, roughly 45 million people in the US lacked health care insurance. The population of the UK at that time was around 50 million, and every one had free healthcare.
I don't understand how a wealthy and resource-rich country like the US could even begin to tolerate 45 million people existing with next to no health support whatever.

The NHS is generally very good with most things but adult mental health issues.

I'm sure the NHS has problems. In fact some google searches will find lots of people unhappy with it. The UK has one advantage though. You are only messing around with one bureaucracy, and you don't have to worry about being without healthcare insurance.
In the US it is a mess because there are multiple systems that all compete and in order to be covered you have to figure out the right doctors and clinics to go to etc. It really is bad mess sometimes and "falling through the cracks" is very easy.

I am sorry to herar you have had such a bad experience but read my post 'here goes', GP's aren't all bad you know, there is hope!

Last edited by Jacs on 08 Mar 2011, 9:48 am, edited 1 time in total.

There's still quite a choice though.
In my town (roughly 22,000 people) there are, off the top of my head, 4 group practices and each would have maybe 7-10 doctors available at any one time. Generally people register with the nearest practice for convenience of access but with any one of them it's possible to phone and make an appointment, which is usually available within 3 days.
Many practices operate a 'drop in' service too, where you can just turn up and take pot-luck with the timing (although they would accommodate anything urgent immediately). Plus it's possible to arrange for doctors to do home visits.
Initially the doctor you'd get is whoever is available and for most cases that's fine - they're all competent - but it's no big deal to request a specific doctor or change at any time.
The waiting lists for surgery aren't too bad, but sometimes it's still quicker to go private. That's the great thing - the private healthcare option is just as available as the free one.

You're talking about your side of the pond, but in the USA, it's not much different except that most GP's don't care and would just give you a referral as they know they aren't qualified to Dx autism/AS.

This is why I don't like the idea of "socialized" medicine. The GP becomes the gatekeeper, and there is undoubtedly a push to only refer on cases that are obvious in need. This means if the GP doesn't think you have need of a referral, you don't get it.

Oh God yes, it's not an efficient bed of roses by any means. But at least it exists and it's free, and on the whole it does an extremely good job.

Yeah. That's a terrible situation and as it stands with me at the moment, I couldn't afford any healthcare insurance if I was required to pay for it.

Not quite as bad as it appears, because you can simply ask to see another doctor who could even be based at another local practice.
My GP was very honest about a referral for diagnosis and we discussed the poor support for adult cases, although he would have done it if I'd pushed because I had a valid case.
There was no obvious need involved at all; it was an issue I'd raised following a long history of ineffective treatments for depression/anxiety/panic attacks.
They're not quite the gatekeepers they're portrayed as and most will do their best with the resources available, including referrals.

Sounds a bit like my Doc. My wife raised the issue to her that I probably have AS and the Doctor explained she didn't know a lot about AS but said she could look into refering me but didn't see the point at the moment as there is no benefits (money wise) for Aspies and as far as she knew there is no cure. She even asked to borrow my wifes books about Aspergers so she could learn more about it. I get the feeling she would put me through the diagnosis system just so she could learn more about Aspergers and how it affects people. Thing is I'm not realy arsed one way or the other if I get diagnosed.

That is very much how it is in Australia, but I have been lead to believe that in the UK you are forced to see certain doctors, which obviously is not the case. We also have a private health system, so people here have both choices. I have chosen not to use my local clinic, the closest one as I do not know the doctors there and I found the one I do see, who is very close and does understand my condition, etc.

What also differs in that in the UK and Australia, GP's are specialists in their own right. In Australia they have a minimum of 4 years specailst GP training, after medical school, the intern year and a number of other years as a junior doctor. After that they can choose to do specailist training and GP's are one of those specialist. They are not just doctors straight out of medical school, they have 4 years of training of the issues and things that are seen in general practice, the role of referrals, how to find specailists, asses their skills, etc, and a broader understanding of difference, disability, etc, etc as they are front line people. Doctors straight out of medical school here are not allowed to work anywhere other than in hospitals under supervision, they are required to be specailists to be allowed to operate in general practice. In that regards they spend about one year full time study peadiatrics, as they see a lot of children, do vaccinations, well children development checks and the like.

In regards to people saying that GP's are gatekeepers, is that all bad. I mean how on earth do I decide if I need to have heart sugery and how do I go about choosing a heart surgeon. What am I supposed to do, ask for their resumes, go and interview them? The fact is I choose a GP, psychologist and Psychiatrist largely on personality. I do not care if a heart sugeron has a personality, I do care that the know how to do their jobs and unfortunately like the rest of the population I have to trust the medical profession on that one. I do however believe that my GP has the ability to assess medical professionals in many cases better than I do. While GP's may not know mental health very much, but then again the mental health system does not know mental health, a significant amount of work is being done here to educate GP's not just about mental health, but also about ASD, and they have in the past 10 years ALL been forced to attend training on mental health and much more is being offered to them and all for free.

My GP does not simply refer me to any specialist. She knows the specialists and she decides which ones she feels are the best and to be honest I like that idea. I like the idea that someone with some knowledge of medicine can give me ideas of where to go to a specailist, rather than me being told that they are all the same.

I also question whether there is choice in the US, as in most cases insurance determines what if any doctor you can see. Doctors work for different insurance companies, so to say that GP's control our health care well I would rather have it controlled by a doctor than a businessman, and that is all health insurance funds are.

The other reality is that we do have private halth insurance and can also go private without it if we like. We can choose, what we cannot choose is who treats us in a public hospital, but we do have the right to ask for second opinion. All mental health care in public hospitals is forced care, involuntary treatment and they have no choice anyway. As for how to choose a doctor for another condition, something I do not know how to do. There is a growing range of different maternity options for women giving birth, to allow them choice of providers, location, etc.

What I do have is a guaranteed level of health care. If I have a heart attack, stroke, suffer a spinal injury or whatever the ambulance officers do not need to ask where to take me and the doctors are going to treat me, without first asking and demanding to know how it will be paid for.

^^ Very much the same system as ours.

Precisely.
Some years ago I was involved in a motorcycle accident which left my hip somewhat mashed up - the bike used me as means of stopping.
This was a couple of hundred miles away from home, but it was just a case of calling 999 (911 equivalent) and an ambulance arrived in a couple of minutes with sirens blaring and I was whisked off to the nearest hospital for examination.
Instant treatment, including X Rays, revealed that it looked worse than it was and I was able to hobble off afterwards (with the offer of free transport, BTW) - but all I needed to do was give the name & address of my practice so the records could be updated.
I got a card from my practice a week or so later to have me in for a further check-up as a result of all this, again with no fuss, no bother - and no payments.

It's worrying to me that people actually campaign against providing this level of healthcare, and you can bet that behind the campaigning are the massed ranks of insurance companies pushing for their private financial interests to be placed before health.
The nature of insurance companies is to dispute; to do everything possible to avoid paying out (and where they do, to then increase premiums) and while this is annoying and causes problems when it involves property etc, it can also result in ruined lives or death when it involves healthcare.
And that's just plain wrong.

Yep.

That and the people who are able to afford it have the "I got mine, so screw the rest of you" attitude. I'd love to move somewhere where I didn't have to worry about paying for expensive health care out of pocket, but I have no idea how to go about doing that.

I had a consultation the other day about my depression/mental health issues. The fella who did the consultation had never heard of Asperger's Syndrome! As you'd imagine, fun and games promptly ensued.

I could not agree more with that. With the recent floods in Australia that have claimed hundreds of lives, the majority of insurance companies are not paying up claiming it was not a real "flood", etc. It is horrible to watch this happening, but it is only housing and possessions and to think that it could be used with someones life is beyone me, which is what happens in private health care. Your not covered by that, we only cover 30 days of hospital care a year, only a few days in intensive care, etc. Tough luck if you need to be in hospital for more than 30 days, need more than a few days in intensive care, etc. Also what happens in private systems if there is some massive disater and they do not have enough intensive care beds or the like in the hospital with your insurance. I do know someone here, who was flown interstate by intensive care ambulance when there was no bed here, for some freak streak of nature. Look at New Zealand and the earthquate, they are flying patients all over the country to any hospital that has a bed. No need to set up field hospitals that cost money and are not nearly as good anyway, when you have real ones just half an hour away.

I would like to point out two observations.

1. She doesn't know what "stimming" is.
2. And she thinks someone with AS can be readily identified by looks alone.

In other words, she doesn't know what she's talking about.

It probably wouldn't hurt to take the vitamin D though. Most people are deficient.