Private Medical Consultations

Patients make arrangements to see a doctor in private practice, in general to have control over:

  • which doctor they see;

  • when they are seen; and

  • where they are seen.

When private medicine works well, the patient is able to choose an expert best suited to their needs.

Choosing a Private Consultant

The Private Healthcare Information Network, recommends considering the following when choosing a consultant are:

  • their registration (and the registration for the facility - e.g. with the Care Quality Commission),

  • their reputation - i.e. testimonials and external reviews on platforms like Doctify, Topdoctor, or Google Reviews,

  • their specialisation, and

  • transparency about costs.

In addition to patient-based reviews and testimonials, the reputation of the doctor amongst other doctors and experts can also be important. This can be ascertained from:

  • the opinion of a local (referring) GP,

  • recommendations from other specialists,

  • recognition through national leadership roles, or invitations to speak,nationally or internationally,

  • good quality peer-reviewed research publications.

Practical issues, which are almost never discussed/shared, but which influence the success of a consultation are:

  • will pre-appointment information (e.g. previous test results, letters and scans) be seen and reviewed by the consultant before hand? A referral letter and relevant background information shared and reviewed before the appointment help to increase the chance of success. The consultation can therefore be focused on moving forward to address the patient’s goals, rather than chasing items of information from the past.

  • how long is the appointment? Often this is not clear, or explicitly stated. Most neurologists allow either 30 or 40 minutes between new patient appointments. 30 minutes between patients usually translates to consultations of around 20 to 25 minutes each, which is suitable for standard and less complex consultations.

  • when will the clinic letter be released? The wait between an appointment and the finalised clinic letter varies markedly across doctors - e.g. from less than 1 day, to 2 weeks. For some patients, the information is needed to inform next steps such as travel. It may therefore be useful to seek this information in advance of being seen.

Specialisation and Expertise

A common view is that specialists have more insight into problems than “generalists”. This view is, however, correct if and only if the problem is narrowly and specifically within the specialist’s domain.

As patients seldom come with a diagnosis, but instead a set of symptoms which need to be understood, the best place to start is almost always with a doctors with a general and broad understanding of medicine. This is why patients seeing private consultants do well in almost all instances to see a *general *practitioner first.

Within specialties in medicine (e.g. neurology), there is an increasing tendency to further subdivision into narrower domains of interest (e.g. multiple sclerosis neurology, headache neurology, or epilepsy). Part of this is a practical consequence of just how common some problems are (e.g. migraine affects 12 in 100 adults). Special interest, and subspecialty experience should not however replace skill and expertise in managing patients whose problems have yet to be fully defined.

In my experience, patients presenting with new symptoms are best served by consultants with a broad, rather than narrow experience base both within general practice, and in medical specialties. For the few occasions where subspeciality input is needed, further referrals can thereafter be made.