ob/gyn

Im a bit nervous about finding a new doctor in Bristol.  I have the most wonderful OB here, I drive from SF to Santa Cruz (1 1/2 hour drive!) to see her because shes so great.  Ive also had some health issues that require me to have a pap done more than once a year.   I will also have private insurance through hubs company.  I dont quite understand how the NHS and private insurance work over there (if you have both).  I also have issues with seeing a male OB (previous bad experience). 
Any thoughts appreciated! 

Im a bit nervous about finding a new doctor in Bristol.  I have the most wonderful OB here, I drive from SF to Santa Cruz (1 1/2 hour drive!) to see her because shes so great.  Ive also had some health issues that require me to have a pap done more than once a year.   I will also have private insurance through hubs company.  I dont quite understand how the NHS and private insurance work over there (if you have both).  I also have issues with seeing a male OB (previous bad experience). 
Any thoughts appreciated! 

Just a few thoughts...

make sure you dont call it a 'pap' when you get here... it's just a 'smear', 'smear test' or 'cervical smear'.

If you have private health insurance, then you dont use NHS doctors... you go to a private clinic, or private hospital, or private GP practice.

Good luck! 

i know how importnat having a gyn you like can be.  i searched and searched in the US- i must have gone through 5 or so b/f i found one i really liked.

in the UK I too have private insurance.  however, perhaps different private insurances work differenetly.  i still have a NHS GP who i go and see every 6 months (for a thyroid condition- regular monitering).  this doctor (who's a woman by the way) writes the RX for my birth control patch and my thryoid mointering.  every three years a get a smear here (if you call it a pap SMEAR they know what you're talking about, but a pap draws blank stares).  i go to a special clinic my surgery has every tuesday.  it's this lovely older nurse who's like the best grandmay person ever.  be warned- they don't do an internal exam as well.  it's just duck bills in, swab away, duck bills out.  there's also no breast self exam or anything. 

if i were to have a problem with my smear and needed to be seen by a consultant/specialist THEN my UK private insurance would kick in.  i would be seen at a private hospital, by a private consultanat.  the big advantage with this is that i would probably been seen much, much quicker (one week rather than up to 14 weeks+ for NHS).

even if i became pregant (not something on the horizon), i would be seen by my GP, and then the midwife.  only if it were a high risk pregnancy or there were complications would i be seen by a ob/gyn.  my private insurance only covers these situations. 

this is my experience with standard life health insurance, and my GP is in the peterborough area.  from what i rememebr from your posts- you're moving to bristol? anymore specific questions just ask. 

thanks so much for all the info.  Im going to register with hubs private GP and go from there.  Im seeing my ob/gyn here end of january and she already gave me 3 months samples of birth control pill I can easily get in the UK.  Ive been off the pill for almost 3 years and cannot handle the horrific periods any longer.  Plus me and hubs are not ready for little feet running around!   

I work for a private health insurance company and can tell you that MOST of their plans are for acute, short-term conditions (with the exception of cancer). Where I work, for the first three years you are a member, you must get a referral to a specialist by your GP. In general, 'primary care' (which would include smears) is NOT covered by private insurance.

This, howver, is the most common scenario. It's entirely possible that your husband works for a company with a bespoke (custom) policy that lets them get away with anything! Regardless, do be careful. If you get to see an GYN and don't like him/her, some insurance companies are a bit weird about you switching.

hubs works for Orange.  I do believe it is a custom policy, but will know more soon.  I did find some good information on the NHS site about "smears".  Although, I think its insane they usually only do them EVERY THREE YEARS!  I gotta find out so more info...  I asked my doctor if shed come with me to the UK, but shes eventually moving to Italy! (HA!)

there's also no breast self exam or anything. 

GPs don't do breast exams as part of a regular physical?  Huh, I didn't realize that this would be different, as it's one of those things that is routine in the US.  Do they just rely on women doing their own self-breast exams and then reporting anything suspicious?  When do they start doing mammograms here?

Although, I think its insane they usually only do them EVERY THREE YEARS! 

This is actually a debateable issue. Some people in the field think women who are not high risk are fine getting a smear every three years provided that the tech who screens your smear is doing their job concientiously. Others feel every year is the gold standard. As someone who screens those smears, I remain very firmly on the fence about it all. It has a lot to do with money when push comes to shove. Run a seach on this topic and you can find some of my mad ramblings on the subject...... 

it was my yearly pap that turned up adnormal cells on my cervix, not far away from being dysplasia.  I had them froze off (not pleasant) and now they are back.  I know this is very common, but if my doctor had not been doing a pap every 3 months for 6 months, then every 6 months for a year, we wouldnt have known they came back.  Im having the freeze them off procedure done again end of this month.  Boys have no freakin clue how easy they have it! 

it was my yearly pap that turned up adnormal cells on my cervix, not far away from being dysplasia.  I had them froze off (not pleasant) and now they are back.  I know this is very common, but if my doctor had not been doing a pap every 3 months for 6 months, then every 6 months for a year, we wouldnt have known they came back.  Im having the freeze them off procedure done again end of this month.  Boys have no freakin clue how easy they have it! 

If you've had problems in the past, then the 3-year smear test may not apply to you. I'm not sure exactly how it works, but it seems to me that there might be different rules for people with preexisting conditions. Anyone?

You are a high risk patient then, and I am pretty sure you will be eligible for more frequent smears in the UK. (Someone who actully knows-confirm please?)

Depending on the strain of HPV you have, the abnormal cells may just regress on thier own after time. The only way to be sure is to have regular screens but be assured that cervical dysplasia is a slow growing entity so as long as you monitor it, you will be fine. Some docs won't treat low grade lesions anymore, preferring to monitor and wait for regression.


(Late post~ Belindloo jumped in before me )

thanks.  The HPV is not present right now, but the cells have progressed into the next stage (very upsetting topic with me right now, blah)  Im going in on Jan 30th, with a list of questions for her too.  Bummed.....

Aww! Hang in there. PM me if you want info sooner. I'm not a doc but some stuff is straightforward.

Best of luck with the 'freezing'...I too had to have it done and it was not pleasant!  I ended up getting smears every 6 mo for a while but haven't had to worry for a few years about it.  My doc did say that if anything shows up next year when I'm due for a pap, then I'd get them MUCH more often - unusual smears definitely bring on more smears...so no worries.  Just bring your info from your current doc and they'll work with it.

I used to go to the US for my smears because I loved my doc there. But I was paying full whack for the privilege. So then I got an 'abnormal' result and it was clear I'd have to transfer my care to the NHS. Long story short, they did another smear, came up with the same results and I've been under watchful care ever since. Needless to say, it will be helpful to have full medical notes with you when you see your first UK doctor.