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<blockquote data-quote="Marguerite" data-source="post: 65523" data-attributes="member: 1991"><p>I do think this is economics, not you being difficult in terms of being a pain in the neck to treat. "Difficult" in that it's more long-term and less 'cosmetic' on the practice books - definitely.</p><p></p><p>If you can somehow do it, I would communicate with your doctor to let her know, at least, of the letter and your decision to go elsewhere. Ask HER who she recommends you see. Surely a referral from her will be to someone who SHE respects as a doctor and therefore may have similar attitudes and values? Also, I would protest the "effective from" date and request a final appointment, for handover and to sort out prescriptions that were postponed - the doctor expected to see you, you expected it too. The button to push with the practice - "it will make the practice look negligent in their duty of care, if I am in a desperate rush to see someone urgently, simply because I was not permitted to keep my scheduled appointment, when the plan was to finalise and organise all longer-term repeat prescriptions."</p><p>If they want to bring your next appointment forward, let them (unless it is too soon for the prescriptions to be written - a problem we have in Australia). At this point you can also request a referral, or failing that copies of your files. In Australia there is still some argument over who owns the files. Freedom of Information applications can often open doors, but not necessarily with patient files. There has been a lot of argument over this - doctors make their own notes, often in their own personal terminology and so such notes have less relevance or meaning to another doctor (and certainly not to a patient who has no medical training! as they tell us). However, they are notes about US, often valuable information can be there which can help.</p><p></p><p>I mentioned that my specialist retired. Several years earlier he had referred me to a rehab specialist for inpatient treatment. At the consult with the rehab specialist my doctor's referral letter lay open in front of him. I am very adept at reading upside down and was very upset by what my doctor had written. But when I took it up with him and argued about it, he told me I had no right to have read it. I said I was glad I had, I didn't realise how badly he had misunderstood me. Soon after I was admitted for treatment by the rehab specialist who lost interest in me when my specialist's letter was proven to be wrong. "She's not so interesting, after all." My specialist then had to take over inpatient treatment and realised HE had been wrong, too.</p><p>When he retired, far from keeping my files confidential, he posted me the lot - it was huge, like a legal file. And it includes ALL the referral letters, including my own vehement protests in writing back to him!</p><p>My GP recently changed practices (again). This time he asked us what we wanted to do, and then with our permission took all our files with him, so we could transfer too. The previous transfer he had been told the files belonged to the practice, not to him. So he was very naughty - I had some X-rays needing to be looked at, he tucked the files in with my X-rays and let me out the side door. He knew he would have been searched. The files would have been no good left where they were, since we were never going back there. My doctor could have argued and made a case for the files being his and NOT the practice's, but he didn't want the legal fight dragging on.</p><p></p><p>Rules change. Doctors detach, constantly. The best assistance you can get in your own medical care is a GP who is prepared to liaise with all your other practitioners/specialists and all. The GP doesn't have to be brilliant, just good at paperwork and prepared to listen. Anything more is a bonus. And a practice that is more concerned about its bottom line - run, don't walk, in a different direction. They're like fair weather friends, who enjoy partying with you but will ignore you or cross the street to avoid you, when life (or your health) turns sour. The ones who stick with you are the true supporters.</p><p></p><p>We live in a world which increasingly needs good quality long-term medical care, and yet we see all around us the burgeoning of medical clinics which only deal with acute care. The reason? The profit line. Not good.</p><p></p><p>Good luck with this one.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 65523, member: 1991"] I do think this is economics, not you being difficult in terms of being a pain in the neck to treat. "Difficult" in that it's more long-term and less 'cosmetic' on the practice books - definitely. If you can somehow do it, I would communicate with your doctor to let her know, at least, of the letter and your decision to go elsewhere. Ask HER who she recommends you see. Surely a referral from her will be to someone who SHE respects as a doctor and therefore may have similar attitudes and values? Also, I would protest the "effective from" date and request a final appointment, for handover and to sort out prescriptions that were postponed - the doctor expected to see you, you expected it too. The button to push with the practice - "it will make the practice look negligent in their duty of care, if I am in a desperate rush to see someone urgently, simply because I was not permitted to keep my scheduled appointment, when the plan was to finalise and organise all longer-term repeat prescriptions." If they want to bring your next appointment forward, let them (unless it is too soon for the prescriptions to be written - a problem we have in Australia). At this point you can also request a referral, or failing that copies of your files. In Australia there is still some argument over who owns the files. Freedom of Information applications can often open doors, but not necessarily with patient files. There has been a lot of argument over this - doctors make their own notes, often in their own personal terminology and so such notes have less relevance or meaning to another doctor (and certainly not to a patient who has no medical training! as they tell us). However, they are notes about US, often valuable information can be there which can help. I mentioned that my specialist retired. Several years earlier he had referred me to a rehab specialist for inpatient treatment. At the consult with the rehab specialist my doctor's referral letter lay open in front of him. I am very adept at reading upside down and was very upset by what my doctor had written. But when I took it up with him and argued about it, he told me I had no right to have read it. I said I was glad I had, I didn't realise how badly he had misunderstood me. Soon after I was admitted for treatment by the rehab specialist who lost interest in me when my specialist's letter was proven to be wrong. "She's not so interesting, after all." My specialist then had to take over inpatient treatment and realised HE had been wrong, too. When he retired, far from keeping my files confidential, he posted me the lot - it was huge, like a legal file. And it includes ALL the referral letters, including my own vehement protests in writing back to him! My GP recently changed practices (again). This time he asked us what we wanted to do, and then with our permission took all our files with him, so we could transfer too. The previous transfer he had been told the files belonged to the practice, not to him. So he was very naughty - I had some X-rays needing to be looked at, he tucked the files in with my X-rays and let me out the side door. He knew he would have been searched. The files would have been no good left where they were, since we were never going back there. My doctor could have argued and made a case for the files being his and NOT the practice's, but he didn't want the legal fight dragging on. Rules change. Doctors detach, constantly. The best assistance you can get in your own medical care is a GP who is prepared to liaise with all your other practitioners/specialists and all. The GP doesn't have to be brilliant, just good at paperwork and prepared to listen. Anything more is a bonus. And a practice that is more concerned about its bottom line - run, don't walk, in a different direction. They're like fair weather friends, who enjoy partying with you but will ignore you or cross the street to avoid you, when life (or your health) turns sour. The ones who stick with you are the true supporters. We live in a world which increasingly needs good quality long-term medical care, and yet we see all around us the burgeoning of medical clinics which only deal with acute care. The reason? The profit line. Not good. Good luck with this one. Marg [/QUOTE]
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