US Physician, UK Consultant

Just want to introduce myself.

I'm a US citizen, currently in Scotland on a Tier 1 (General) Migrant visa.  I went to medical school in the US, where I also completed a residency in internal medicine, and was an assistant professor of medicine in the US for 5 1/2 years before moving over to join NHS last year, where now I'm a consultant in acute medicine.

Three years ago I looked into practicing medicine in the UK and had no clue.  I remember what it was like to have to discover everything the hard way and how much I wished to have someone who knew first-hand about healthcare in the US and UK available for questions.

As people on talk.uk-yankee helped immensely with my understanding of the visa process, I'd like to give a little back.  I think I'm perhaps a little lonely for expatriate contact as well!  Therefore, if you're a US-based healthcare provider with questions about coming over, or a layperson expatriate wondering about how to interact with the healthcare system in the UK, I'd like to make myself known in the hopes that I can help, and perhaps learn a little more about life on this island in the process.

I regret that, as it's impossible to engage in a viable patient-doctor relationship without a meeting in person, I will be unable to give specific medical advice for individuals or specific conditions on this forum, and therefore will ignore such requests for information.  My recommendation is that, if you require specific medical advice, you always visit with a healthcare professional about your questions or concerns.

That being said, please feel free to contact me for assistance on any other issue you feel I could be of help.  You can contact me on this forum or drop me an e-mail; give me some time and I'll do my best to respond!

I only just saw this. Hi and welcome (again?) to UKY! 

Maybe this needs to be moved to Welcome Wagon?  Please help, Mods!  Thanks!

Hiya RS,
Im a US born,bred and trained RN that came over here in 1999 on a work permit. Like you I really had noooo clue other than I knew that I wanted to work and live in Scotland. For me it was my heritage (gran was born here in scotland) I got my first job via a agency that is no longer about,or maybe has changed.. they did the work permit stuff for me and also helped with the whole visa process. I had already gotten licensure with the then UKCC now NMC as I knew I wanted to try working over here. So im another US healthcare person in the UK and also in Scotland.. I live over in Fife these days.. my first job was up in Aberdeen at the Aberdeen Royal Infirmary. Welcome to the forum. Always nice to have another healthcare person about.
Are you at the ERI???
Anyways Take Care,
Kay

Yes.

Where in Fife are you working?  What area of the hospital do you work in?  If you're in an assessment unit, you and I might know the same people, depending on which hospital you're at; I visited Stirling Royal Infirmary in Oct. 2008 while canvassing for consultant posts in the area.

Hiya
My first job here in Scotland was up in Aberdeen on one of the Cardiology Wards.
I am in the community now. I have worked in medical/renal(last year) at QMH and quite a few medical wards as I'm on the nurse bank and before that I was with one of the Nursing agencies before the NHS stopped using them for the most part. When I did that worked all over in medical wards from the ERI to SRI to the Fife Hospitals.
When I was in the US I worked on a combined general Medical/Surgical/Telemetry Unit.
Are you enjoying ERI?? Bit manic in that assesment unit at times. I know last I worked there was before they planned to enlarge it.
What speciality are you in?
Take Care

I'm a consultant in acute medicine.  I split my time between the assessment area, a rapid followup clinic, and the general medical wards, one of which I'm professional lead for.

In the US I was a hospitalist at an urban academic tertiary-care referral hospital--a lot like the RIE--where I was head of the physician education arm of our section.  Uniquely when compared to other US academic hospitals, I was also involved in providing critical care for 25% of my time, as there was a chronic shortage of pulmonologists relative to our critical care needs.

I miss working in intensive care quite a lot, and I miss my old colleagues.  There are frustrations that come from working in a new system with new values, of course (especially end-of-life).  Otherwise I enjoy where I'm at.  I especially enjoy the improved work-life balance, the chance to devote more time to things that develop my career (like publications), and the clinical responsibilities feel as heavy as a feather compared to what I used to see in Atlanta.  Best of all, I enjoy spending my paperwork time on things to improve the hospital or patient care instead of on things to get paid or to avoid being successfully sued.

The combined assessment area is going to be enlarged again in the next several months, so it might look quite different when you come by again, depending on which wall they decide to knock down.

By community, do you mean you're working as a District Nurse, or in a GP office?

That is very kind and thoughtful of you to make yourself available to those with questions about the road you've travelled.  I know that UKY has been so helpful to me. 

I work with the Paediatric Home Care team..
So with children in their homes.We also have a respite home that is co run with social services. I've been doing this particular job for less than a year ..
Differant than the wards for sure.
Aye definately strange to get use to a differant system,new values. I too like the better work/life balance
Glad to hear you are enjoying things overall.

That's really nice of you!

Here's some questions for you:

Do you have any advice on how one makes sure they're getting the best care possible?  Since  one typically has less than 10 minutes, if they're lucky, with their GP, how can we as patients make sure we leave feeling comfortable with the plan forward? 

I, for example, have had loads of health issues since I moved to the UK, including a week in hospital.  I've ended up, in lots of times, really feeling like I am annoyance to the doctors because I know something is wrong, but all the easy-cheap tests  (i.e. blood, urine) I have had have not left anything conclusive, and I've had to really drag my feet and make myself annoying to get further tests (and finally the random odd tests are showing something rare and we're trying to sort it out now). But it seems like a great reluctance to test further to find something, and easier to just say I'm fat and need to lose weight. (which,although is a true statement, I had this problem when I weighed a lot less then I do now, thanks to this stupid thing I have I've gained 3 stone in a year.)

It seems like we either wait way too long to see the GP and its serious, or we show up all the time and they think everything is all in all in our heads.  (That is the worst feeling in the world to be told something is all in your head.)

So what's your advice in making sure we get the best care?

Phatbeetle,

Ask your doctor questions, and share your concerns with your doctor no matter how silly they may seem to you.  If you feel that your doctor cares about you and how you're doing, is honest with you through the good and bad, and is able to say "I don't know, but I'm willing to do what's needed to find out" when circumstances merit, then you've found a doctor that will help maximize your chances of getting the best care possible.

For whatever reason, if you don't feel that the above apply to your doctor, then it would be best for you to find another one if you can.

For further advice and perspective on this topic--and what you can do during the doctor-patient interaction to maximize your chances of receiving the best care possible--I recommend you read "How Doctors Think" by Jerome Groopman.



I hope this is what you're looking for.

Thanks! That book looks interesting.

In my case, my GP is fantastic (after I went through many) and he listens and cares and fights for me. (Though many on here have trouble with their GPs)

My problem happens when I finally get in to see a consultant, who I have no choice in who I see, because I have to see whoever the NHS assigns me, at whatever appointment time they want to see me at, they're the ones who act like I'm wasting their time and I'd be fine if I lost tons of weight and that things are all in my head.   And way up here in Northern Scotland, depending on the specialist, you may not get to see a different one at all and you're stuck with who you've got.  So what do you do in this case?     

Usually, I have to go back to my GP and explain that it was pointless and he has to fight for me, which wastes his time that he could spend with other patients and then I feel bad.   

I don't have any easy answers for your situation.  The truth is that, practically, healthcare choice is always finite in scope and ultimately you may very much be stuck with who and what you've got (i.e., in Northern Scotland, or anywhere else for that matter).  Nothing I can advise will change that.

If you're given a diagnosis you don't believe, you should say so and ask the physician to explain to you why they are arriving at that diagnosis, then weigh their explanation as per your best judgment.

Apart from what I've said here and above, I don't know how else to advise you.

Thanks.  That's helpful