Private Psychiatry and GP

[anabelle]

Hello,

I have recently self referred to see a private Pyschiatrist (after much personal research into various private services). I had my first appointment recently and found it fairly positive in terms of a least being listened to (I think) rather than being 'judged' from a set of pre existing notes.

My GP is one that who whilst at first very good became part of the team heading up GP control of funding and has since started exhibiting the arrogance and smugness of a coalition politician. He has been disparaging of Pyschiatry in general and continually attempted to persuade me that he was the mental health expert and that Pyschiatry was something I should be very wary of. This is despite having my having had 'mental health' issues for over 30 years and seeing numbers of NHS Pyschologists and Pyschiatrists sporadically over the years.

My point was that he has sort of suggested that as he is not going to be the prescriber of my mental health medications (his ego often appears) then he doesn't really wish to have to take responsibility, that is deal with, issues I might have with side effects and so forth.

A private Pyschiatrist is hugely expensive for a normal person to afford and is not a step one takes lightly. I did expect some recognition for taking a positive step toward my own care by doing this and for my GP to want to work with me over this but he has taken the opposite approach. I want to leave the surgery now as any other doctor I see there is seeing me through his filter first so there is no independence. The problem of course is this is a big step whilst coming off existing medication and starting new ones. Change and conflict as most people on here will recognise are hugely distressing so I am inside this huge whirlwind at the moment and distressed.

I don't want to over strain this new relationship with my Pyschiatrist as it is a beacon of hope for me and I couldn't face the feeling that they might reject me as well or at least disappoint me by not being as helpful as I might wish.

This white box is just allowing me to push my thoughts out, so thank you for that. I dont expect anyone to even read this to be honest or reply. Perhaps by chance there may be someone who has encountered something similar. If I don't post at all I will never know.

Anabelle x

[Elen]

Not exactly the same situation as you but I was referred outwith my GP to a pyschiatrist who changed my medication.

My GP did act a bit hurt over it but recently has seemingly appreciated that their input is valid.

I would say if you do not trust your doctor it can make the relationship hard between you.

Not much help but just to let you know that you are not alone.

Elen

[anabelle]

Thank you Elen,

It is good to know that your GP has been more responsive to the additional input. I wish you well with your efforts to feel better. I would personally welcome other thoughts if I were a GP as long as they were not suddenly radical.

I found the private Pyschiatrist to be very sensible about viewng things holistically and not just looking at prescribing lots of medications. I personally think dialogue about improving quality of life would be very good. Sadly vanity and ego in many professions sometimes get in the way of honest common sense.

Anabelle

[ElizabethJane]

Hi Anabelle. I see my psychiatrist privately too. Your GP cannot refuse to support you when you come off your meds. He has a duty of care towards you. Usually my GP will liase with my psychiatrist regarding any meds that are prescribed. She will 'convert' a private prescription into an NHS one. A word of caution here. Some private prescriptions are the same price as NHS ones. Unless you have a pre payment or exemption there is no saving there. Most surgeries have to act within strict guidelines as to what they are allowed to prescribed. Something like pregabalin for example might not be on the list. Once you have settled on your new meds you will need to find a GP who you can trust for regular monitoring. I see mine once a month. I see the pdoc rarely about once a year. He has always made himself available to me. If I have a query then I can phone his secretary. He will then ring me back or get her to ring me. It sounds to me as if you have a lot of issues going on apart from the new psychiatrist and relationship with your GP. You could try discussing these with your psychiatrist at your next appointment.EJ

[LAURA48]

My GP seemed happy when I said I was going private (saved him the cost of a referral) as the NHS Mental Health System where I live is appalling the best they could offer me was either a Gateway Worker or a Psychiatric Nurse - and I have been pretty bad - have never previously bothered by GP in 15 years as was steady on an antidepressant but stopped working in November and have had a pretty rough time of it hence going private - think I am sorted for once and had a diagnosis of Pure OCD - very expensive though but glad I have good parents who are paying for me.

Have been put on Venlafaxine XL - I did mention this to my GP who looked scared to death about the drug! months ago.

Imo you are doing the right thing.

Take care Laura

[anabelle]

Dear Elizabeth Jane & Laura,

Many thanks for giving me some additional insight into all of this. I fully agree that the NHS has that duty of care and equally understand the massive strain that Mental Health services are under. I also feel as you say it something that the NHS should welcome when a patient says I am willing to fund some of my care myself. The vast majority of people who fund private Pyschiatry are not wealthy individuals as the media would have us all believe (source American Pyschiatric association).

I haven't been prescribed anything revolutionary or mixed exclusively in Dr Jekyll's laboratory which my GP sort of hinted at. I have been given a choice of medications one of which is the same as yours Laura and told to do my own research via a special pharamacological website link and to then email my thoughts back to the Pyschiatrist. We will then discuss matters further I assume.

Yes it is expensive but then so is not having a life and being entirely unproductive so for me it seems worth at least trying despite the immediate financial sacrifice. I wish some GP's were more in tune with the day to day difficulties people have. One shouldn't have to be presenting as some Freudian model of female hysteria to actually have notice taken of them.

I think the harmful anti disability campaigns run by the government and allied newspapers do make life more intolerable as they insidiously plant these seeds about people that are ill not actually being ill and I for one have certainly noticed a change over the last 2 years within the NHS in terms of how I am treated. This was not the case with my private appointment so it does leave one very cynical. I find the cost of understanding has risen along with most other things lately.

Anabelle

[ElizabethJane]

Dear Anabelle I'm sorry that you have been treated badly within the NHS. I have always been treated with dignity and respect both within the NHS and in the private sector. I am only able to go private because hubs has private medical insurance. It has proved useful in the past. I am able to go to see a private psychiatrist but then see my NHS GP. They don't treat me any differently. I agree that the NHS has changed and if you can afford it then accessing treatment is quicker privately.EJ

[eight days a week]

I am sorry, I only have a few minutes tonight, so I shall try to put it concisely (and only as far as I understand it).

In Britain an NHS GP has a legal duty to do what is right by his or her patients. If he does not (e.g. you go to him or her and tell them your problems, and discuss it with them) and anything happens to you or those close to you as a result of inaction or improper action on their part, I believe they will be investigated, and possibly even prosecuted and so losing their license to practise medicine.

You are being palmed off imho. And not even to an NHS psychiatrist, you have felt the need to go private! Don't get me wrong, I have seen private psychiatrists myself and some of them are fantastic (and much better than the NHS - at least they listen to you), but I don't think that's the point here.

For me your GP is looking (and seems to have found) a way to pass the buck for responsibility for your care along to someone else - and that is very, very wrong in my book.

Make sure your GP feels responsible for your healthcare please :)

[thetube82]

must admit am confused why this is posted under the 'Therapy' section, not unless 'medical therapies' are including here.....................

thetube82

[LAURA48]

Anabelle

Do not feel guilty about going private. The psychiatrist I see works for the NHS too and is clinical lead for the area I live in.

My first consultation was £300 for 1.5 hours then £200 for 45 mins thereafter with CBT therapy too. I really wanted medications sorted out - as my old GP (retired now) hadn't a clue! I have a correct diagnosis of Pure OCD and whilst SSRIs are the usually the med given for this condition - just making me much worse - hence the Venlafaxine XL.

It is strange though with the NHS Mental Health system - just a postcode lottery. Even the psychiatrist said to me - I am surprised you are having to pay?? I work for the NHS! too! I told him all the Gateway Workers I was being referred to I knew very well as work colleagues - how awkward is that! Basically in my area unless you have a"plan" and the Mental Health Crisis Team are called in you stand no chance in seeing one.

You will find Anabelle that many people on this site have had to go private unfortunately.

Hope you get sorted.

Laura x

[Richard1960]

10 years ago when i had a really bad episode i was referred to see a Physiatrist under the NHS i had a really postitive expierience,they did not work off of notes but started afresh and they did listen,and it really helped a lot,so it is not always necessary to go private.

Although if i had to be reffered today i do not know what it would be like,but i have no reason to believe my GP would not refer me on if needed,i take the view i have paid in and the services are there they just may take a bit of niggling to get there.

But i guess it varies area to area.

Richard.

[anabelle]

Thank you to everyone who kindly gave their thoughts on this.

I have sort of realised that with private Pyschiatry perhaps thre is some sense (however imagined) of progress because this level (seniority) of Pyschiatry might never be made available otherwise. They of course also practice in the NHS but can one wait the timescales to see them?

I am not sure I felt much more other than (based upon who my Pyschiatrist is) confidence that the medications would be accurately prescribed based upon (typical) presentation. I imagine time will reveal how constructive the choice was. I think I paid a lot to finally hear someone say that I could slip under NHS radar as increasingly funds are pushed to chronic cases and life saving interventions and as such I hover in this middle ground that the NHS is slowly divesting itself from. To me of course it is serious so I have to take charge of that myself, hence the Pyschiatrist.

I think the Pyschiatrist would be happy to take charge of things but they clearly can only issue private prescriptions and they only want to discuss my care at several hundred pounds + per meeting so it isn't really possible to not also be working alongside my GP (despite differences) for the private road would be far too expensive to solely go down.

I guess unless one has a bottomless pit of money then there will always be this dual track that isn't perfect but one has to work with in order to do what can be done to get 'better' hopefully.

Thank you Anabelle

[joy]

I see private pyschatrist but faxes my gp so the prescriptions are on the NHS so I only pay his fee whih is high enough but the NHS mental health service round here is rubbish

joy

[LAURA48]

Ditto your comments Joy.

[youonlyliveonce.com]

Ditto Laura48 + joy's comments.

I get my first prescription private and then on from the NHS.

I think some GP's are receptive to psychiatrists including private ones, others think they know it all. Personally if my GP didn't prescribe/do as my shrink said I would take the action of finding another one.