Is 'tell a this kind of doctor' an American approach?

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KT67
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28 Feb 2021, 4:08 am

When it comes to medical stuff?

I normally just go to my GP and if I had a serious thing wrong with me, the GP would tell her colleague at the hospital and get me referred.

Is that the way it normally works for British people? Or am I missing out?

I feel like if I just approached a higher level/less general doctor, they would: 1 tell me to go to my GP first and 2 I wouldn't know who to approach and 3 if they did hear me out they'd hear me out less seriously than if another doctor told them my symptoms.

Dentists and opticians are the exception to this. But dentists and opticians tend to be private sector not NHS. So it feels different.

Another exception is A&E. Because it's an emergency. But I'm fortunate in that that has happened twice in my life, once that I was too young to remember, both in childhood.


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OutsideView
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28 Feb 2021, 9:43 am

Our little one has a rash on his chin so I was looking at a website about it that said you should see your pediatrician if it doesn't go away in a week. Reading it out to my husband this morning I said "It says see your doctor, well actually it says 'pediatrician' so it must be American".

Being in Britain I'd definitely only think of 999, 111, A+E, GP or the chemist depending on how bad something was, unless I'd already been refered somewhere like the midwife.


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steve30
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28 Feb 2021, 12:43 pm

With the NHS, you would need a referral from a General Practitioner in order to see a consultant. You may be referred to the consultant through other routes, but its unlikely you'd go directly to one.

If you are already being treated for something by a consultant (or other specialist), then you can probably just make an appointment with them directly.

It is logical to see a GP or similar in the first instance as they may be in a better place to help you, there may be tests that they should do first (before you see a specialist), and there may be other people they can refer to you. Therefore, seeing a GP in the first instance will likely be much cheaper than going directly to a specialist.

I gather in some countries, patients tend to have more 'direct' access to specialists.



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01 Mar 2021, 9:58 pm

OutsideView wrote:
Our little one has a rash on his chin so I was looking at a website about it that said you should see your pediatrician if it doesn't go away in a week. Reading it out to my husband this morning I said "It says see your doctor, well actually it says 'pediatrician' so it must be American".

Being in Britain I'd definitely only think of 999, 111, A+E, GP or the chemist depending on how bad something was, unless I'd already been refered somewhere like the midwife.


I'm in Canada & am pretty sure the American system operates very similar to us. Here, a paediatrician isn't considered a specialist - not in the sense that you should see a GP first and then get a referral to see one. Paediatricians are essentially on the exact same level as a GP in the org chart. Many people have their GP as well as a Paediatrician for their kids - especially while they are very young. Then as they age I think the process is that eventually they age out of their Paediatrician and are seen by their family GP instead. Not sure if any Paediatricians continue to see their Paeds patients forever and become their Family Doctor in a GP role over time or not tbh ? But I somehow doubt that someone is going to specialize in Paediatrics and then only be a Paediatrician for the very beginning of their career and then just evolve into a GP as their first patients grow up.

But anyways, people tend to have a Paediatrician for their child, so they can make an appointment to see them directly just as someone would with a family GP. It's only for Other types of specialists that they need a referral - commonly to an Earn Nose & Throat specialist, for example, or a Gastrointestinologist, or Physiotherapist, or Allergist, or Oncologist, or Radiologist, or Optometrist, or Psychiatrist etc etc - but Paediatricians work in parallel to GP's here & Most People tend to have a regular one for their child or children.


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magz
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02 Mar 2021, 4:15 am

We have a mixed system with public healthcare supplemented by private practices.
If you go the "public route", you go to a "first contact doctor" who refers you to a specialist.
On the "private route" - including private insurance - you can go directly to the specialist.
You can freely mix both routes so people often e.g. choose to see a specialist privately to save time and then get refered to a public hospital for treatment they wouldn't afford privately.


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KT67
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02 Mar 2021, 4:16 am

goldfish21 wrote:
OutsideView wrote:
Our little one has a rash on his chin so I was looking at a website about it that said you should see your pediatrician if it doesn't go away in a week. Reading it out to my husband this morning I said "It says see your doctor, well actually it says 'pediatrician' so it must be American".

Being in Britain I'd definitely only think of 999, 111, A+E, GP or the chemist depending on how bad something was, unless I'd already been refered somewhere like the midwife.


I'm in Canada & am pretty sure the American system operates very similar to us. Here, a paediatrician isn't considered a specialist - not in the sense that you should see a GP first and then get a referral to see one. Paediatricians are essentially on the exact same level as a GP in the org chart. Many people have their GP as well as a Paediatrician for their kids - especially while they are very young. Then as they age I think the process is that eventually they age out of their Paediatrician and are seen by their family GP instead. Not sure if any Paediatricians continue to see their Paeds patients forever and become their Family Doctor in a GP role over time or not tbh ? But I somehow doubt that someone is going to specialize in Paediatrics and then only be a Paediatrician for the very beginning of their career and then just evolve into a GP as their first patients grow up.

But anyways, people tend to have a Paediatrician for their child, so they can make an appointment to see them directly just as someone would with a family GP. It's only for Other types of specialists that they need a referral - commonly to an Earn Nose & Throat specialist, for example, or a Gastrointestinologist, or Physiotherapist, or Allergist, or Oncologist, or Radiologist, or Optometrist, or Psychiatrist etc etc - but Paediatricians work in parallel to GP's here & Most People tend to have a regular one for their child or children.


Yeah it might have changed nowadays or it might have been cos I was dyspraxic but I always had a different doctor to my parents growing up til I was older & I think that doctor was a paediatrician.

I had one really bad experience with mum's GP though.

Mum said '[he] won't take the eye drops because [he] has sensitive eyes and doesn't like things put in them'. GP said 'pin [him] down then'.

Not decent advice even for an NT kid. Seriously? Pin a kid down? Even metaphorically that is violent.

Being an autistic kid, I interpreted that as 'put nails into him and staple him on the floor as you force eye drops into his open eyes which might be pinned open' 8O

I had a meltdown & mum says she didn't blame me.

Idk if mum knows I took it literally...

Paediatricians are better at talking to kids. Even NT kids tend to be a bit literal and easily scared. They use words that the kid understands and talk partly to the kid as well as to the adult.


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KT67
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02 Mar 2021, 4:18 am

steve30 wrote:

It is logical to see a GP or similar in the first instance as they may be in a better place to help you, there may be tests that they should do first (before you see a specialist), and there may be other people they can refer to you. Therefore, seeing a GP in the first instance will likely be much cheaper than going directly to a specialist.


Cheaper to who though? The general public/NHS?

I've never had to pay for anything medical except emergency dentist & glasses.

It's maybe done partly as a cost avoidance tactic but I think it's a good thing for the patient as well for the reasons you've mentioned.


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goldfish21
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02 Mar 2021, 10:27 am

KT67 wrote:
steve30 wrote:

It is logical to see a GP or similar in the first instance as they may be in a better place to help you, there may be tests that they should do first (before you see a specialist), and there may be other people they can refer to you. Therefore, seeing a GP in the first instance will likely be much cheaper than going directly to a specialist.


Cheaper to who though? The general public/NHS?

I've never had to pay for anything medical except emergency dentist & glasses.

It's maybe done partly as a cost avoidance tactic but I think it's a good thing for the patient as well for the reasons you've mentioned.


It’s for cost and supply/demand scarcity management of Human Resources.

GP’s get paid less than in demand specialists, so it saves money. Many times GP’s can resolve issues and there’s no need to bother with a specialists.

Specialists tend to be higher paid And there are fewer of them in high demand with long waiting lists. That’s why people need a referral from a GP - they’re the professional gatekeeper that decides whether your case is worthy of escalating to an appointment with a specialist so that none of the specialist’s valuable time is wasted dealing with a patient care they should be.


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