Seeing an OBGYN on NHS

Thank you all for your helpful responses! I have to admit that it makes me uncomfortable to think about just going to my regular GP for well woman care. I also don't like that pap smears (uh, "smear tests") are only every 3 years.

Well...you're likely to be a bit frustrated and/or disappointed if you tend to think of the NHS like that.

Ugh. Thing is, I was making a negative comparison! I hated my HMO!! I was so happy when I could be on a PPO!! I hate having to ask permission from one doctor to go see another one. Like I'm so stupid that I don't understand that a back doctor is for when I have back problem or whatever. For example, I have exercise induced asthma. I normally see an allergist here. Will it be a big deal to get a running script for an inhaler?

You can also visit a Family Planning Clinic, if there is one in your area, for birth control, sexual health problems, emergency contraception and well woman checks.

Just look them up and make an appointment, no referral needed. I used to prefer the FPC to my local GP as FPC doctors specialize in OBGYN. The one in my area had early evening appointments which was very convenient.

Interesting. Would you say your experience was similar to going to an OBGYN or more like a walk in clinic? Any details would be appreciated! Obviously, DH can't really help with this since he doesn't usually need an OBGYN.

Thanks, again!

It's more like a walk-in clinic.  I never saw the same person twice, although given that it is every three years it is entirely possible the people I saw moved on.

They do the smear; they don't check your breasts or anything else.

For example, I have exercise induced asthma. I normally see an allergist here. Will it be a big deal to get a running script for an inhaler?

I wouldn't think so.  They seem to hand out inhalers for all sorts.  When I lived in London, I developed a constant cough (the docs said it was probably me getting used to the pollution, having just moved from Scotland.  I have no opinion on that.)  And they gave me a prescription for an inhaler.

Would you say your experience was similar to going to an OBGYN or more like a walk in clinic? Any details would be appreciated!  

I am going tonight, for my 12-weekly depo jag.  I made the appointment last time I was in.  I will walk in, let them know I am present, they will check that my address is still the same, that I am still with the same GP, that I am still happy to have letters sent to my home address.  They will ask me to write down the reason for my visit... rather than saying it out loud, for privacy... it's a busy waiting room with lots of people within earshot. I will wait 5-10 minutes, and then a clinic person (sometimes it is a doctor, sometimes a nurse, sometimes male, sometimes female... i rarely see the same person twice.) will come out into the waiting area, call my name and take me to the exam room.  We will sit down, have a 5 minute chat about whether or not I am still in a monogamous relationship, do I have any concerns, am I taking calcium?  Due to my age, they will ask me if I am having any symptoms of menopause(!)... they will probably lecture me about my weight too, if they are following previous form!  

Then I will walk over to the table, bend over, pull down one side of my trousers, and she will give me a  jag in the bum cheek, and say 'see you in 12 weeks!' and I will make another appointment at the front desk before I leave.  It's fairly casual.

Ugh. Thing is, I was making a negative comparison! I hated my HMO!! I was so happy when I could be on a PPO!! I hate having to ask permission from one doctor to go see another one. Like I'm so stupid that I don't understand that a back doctor is for when I have back problem or whatever. For example, I have exercise induced asthma. I normally see an allergist here. Will it be a big deal to get a running script for an inhaler?

I think we all like to see 'specialists' for whatever problem it is, regardless of what it is, makes us feel better or more secure, or whatnot? Afterall its our health!  We all want to go straight to an ophthalmologist for our eyes, an allergist for our rashes, an orthopaedist for our knee pains, as we see them as the best, that's their speciality!   But this is actually quite costly and doesn't mean that our treatment will actually be any better.  The thing is, so many conditions are very common and GPs are very competent and trained to handle so many different things.

(Before I moved here, I had a PPO and saw various specialists for eyes, allergies, OB-GYN, etc, and honestly I can't say that actually one of them were any better than my GP.)

Here's a leaflet called a patient guide to GP services, that explains so much of what GPs services are:  http://www.nhs.uk/choiceintheNHS/Yourchoices/GPchoice/Documents/rcgp_iyp_full_booklet_web_version.pdf

If you do feel that you need to see a specialist, (i.e they're getting nowhere, you're in constant pain, the medication isn't working, you instinctively know something isn't right)- you do have the right to request one:  http://www.nhs.uk/chq/Pages/1094.aspx?CategoryID=68&SubCategoryID=158

I spent months going back and forth and back and forth and in and out of hospital, with all kinds of negative tests and actually a few different specialists until I finally got to the Rheumatologist and my autoimmune condition was diagnosed and I finally got some medications and things that actually made me feel better.  So do discuss this with your GP if you want to see a specialist for any reason.   And switch GPs too if you don’t feel like you’re getting the care you need or deserve.  

I know as Americans we do fear the NHS, but actually once you get into it; it’s a good system, just different. And its actually really great to know you can lose your job and still get excellent care.  

I normally see an allergist here. Will it be a big deal to get a running script for an inhaler?

It wont be difficult to get an inhaler, but it will be from your GP. There is no way you will get a referal to an allergy specialist as there are only very few in all of the UK. People at risk from anaphylaxis often can't even get referals to allergy specialists.

I can only give positive reports of the FPC's I attended in the UK. As far as comparing to an OBGYN in the US I'd say that the surroundings might not be as plush, but I received comprehensive care and always had complete well woman checks.

Just remember it is a different system from the US!

For example, I have exercise induced asthma. I normally see an allergist here. Will it be a big deal to get a running script for an inhaler?

I asked my GP for a refill on my US inhaler scripts and she was able to get me the UK equivalents with 12 refills.  My surgery has an "asthma clinic"  where I get an annual check-up with a nurse and can make non-urgent appointments as desired. Urgent appointments would be with the on-duty GP and for emergencies I would go to A&E at the hospital.

I think we all like to see 'specialists' for whatever problem it is, regardless of what it is, makes us feel better or more secure, or whatnot? Afterall its our health!  We all want to go straight to an ophthalmologist for our eyes, an allergist for our rashes, an orthopaedist for our knee pains, as we see them as the best, that's their speciality!   But this is actually quite costly and doesn't mean that our treatment will actually be any better.  The thing is, so many conditions are very common and GPs are very competent and trained to handle so many different things.

I just wanted to echo this.  

The US system conditions you to expect specialist treatment but it isn't always better or necessary.  My UK GP was excellent and incredibly well versed in many areas and when I really needed specialist care, I got it.  I do appreciate that everyone's experience is different and there are certainly bad UK doctors (as there are in any country) but remember that should be treated as the exception.

Thank you all for your helpful responses! I have to admit that it makes me uncomfortable to think about just going to my regular GP for well woman care. I also don't like that pap smears (uh, "smear tests") are only every 3 years.

It was helpful for me to get used to the NHS by understanding what makes this system different from the US.  IME, the US system is based on testing you for every possible issue because, if something is missed, they risk getting sued.  Also more tests and analysis means more money.  Most of this is unnecessary, particularly if true evidence based care and a bit of common sense is exercised.  IME, the NHS takes a more evidence based approach - targetting your primary symptoms in the most obvious manner first.  The NHS also relies on you to know yourself and to speak up for what you need.  Funnily enough, I am struggling with the US system now that we are back in the US for a few years.

On the pap smear issue, it is actually recommended in several first world countries for smears to be done every 3 years - the US included.  You can google "pap smears every 3 years" and see that leading US organisations have been recommending this for years.  However it isn't really catching on in the US because doctors can bill for those annual tests and as patients we are conditioned to think that more tests keeps us safer.

ETA: I just wanted to emphasise again that these are my experiences and opinions.  I understand healthcare is emotive and I am not wanting to cause offense to anyone with different experiences or opinions.

It was helpful for me to get used to the NHS by understanding what makes this system different from the US.  IME, the US system is based on testing you for every possible issue because, if something is missed, they risk getting sued.  Also more tests and analysis means more money.  Most of this is unnecessary, particularly if true evidence based care and a bit of common sense is exercised.  IME, the NHS takes a more evidence based approach - targetting your primary symptoms in the most obvious manner first.  The NHS also relies on you to know yourself and to speak up for what you need.  Funnily enough, I am struggling with the US system now that we are back in the US for a few years.

On the pap smear issue, it is actually recommended in several first world countries for smears to be done every 3 years - the US included.  You can google "pap smears every 3 years" and see that leading US organisations have been recommending this for years.  However it isn't really catching on in the US because doctors can bill for those annual tests and as patients we are conditioned to think that more tests keeps us safer.

This is exactly my view also.

However it isn't really catching on in the US because doctors can bill for those annual tests and as patients we are conditioned to think that more tests keeps us safer.

Interesting- here's a timely article from the wall street journal: Value of Medical Checkups Doubted

When I first moved, I thought going to your GPs office for OB-GYN services was strange too.  But I've quickly gotten over it as I've had nothing but excellent experiences. 

Almost immediately upon moving over here, I was due for a 6 month check up on a minor breast issue I had back in the States and a refill on my birth control.  My GP talked me through my pill options to help me find the closest version of what I took back home, and was extremely knowledgeable.  I mentioned the breast issue and I don't think I had even finished talking before he said he was going to refer me to a specialist.  (The specialist was amazing and noticed errors in the US diagnosis right away.  They did more tests and discuss the results as a panel so there's less reliance on one interpretation.)

They also didn't blink when putting me on yearly smears because of a past issue.  If there's even the slightest reason, they don't seem to hesitate to do that.  I frequently has a nurse do the test back in the States, so I don't mind one doing it here.  It's strange not having stir-ups though!!

Don't worry about going through your GP for more than you're used to.  It reminds me of when I was a kid and my mom took us to our pediatrician for EVERYTHING.  A good practice is key though.  Ask around, get references, or register somewhere else if you're truly unhappy.  There are some great doctors in this country, so try not to be put off by the slightly different set up.  Just enjoy no co-pays and free birth control!

Do people in the US go to an OB/GYN for smear tests? I guess I'm just wondering why the UK system of seeing your GP for that seems to alien to everyone, because when I lived in the US I always just went to my primary care physician for smears - and just about everything else too. It was extremely rare for me to see a specialist. I did get referred to one for my psoriasis, but then I see a consultant for that here too, so there's no difference.

I think it depends on your insurance. I had Kaiser when I lived in CA and at the time we were assigned to an OB-GYN for our smears.  I do know that Kaiser were one of the HMO's considering switching to a 3 yearly interval for smears, but don't know i that was ever implemented.

Well said, Sara.

 The NHS also relies on you to know yourself and to speak up for what you need.

I know the OP didn't mean for this to be a debate and that everyone's experiences differ, but to me, this is the problem. I'm not a doctor. I don't know what I need.

Three years in, I now ask my GP (or whatever person I happen to see because I don't think I've ever actually seen the person who is supposed to be my GP) for specific prescriptions and they always give them to me, but that's not comprehensive healthcare, IMO.  I shouldn't rely on WebMD to be my doctor and use a real doctor only as a person to fill out a script pad.

I've gone through four or five types of birth control because they won't take the time to TALK to me about what it is I don't like about one and just throw another at me hoping it will be better.  I also have a recurring issue that I went to the GP once to check out and he just tossed some antibiotics at me without asking me anything about it. It keeps coming back and keeps going away without antibiotics and I've self diagnosed it as something benign, so I don't bother to go back, but why don't they care what it is?