england

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Re : england

Postby helenw » Tue Apr 26, 2005 02:05 pm

Well I think that is ridiculous! On the NHS here we don't directly pay for our medical care, it is paid from taxes. So we get treated as patients, not clients in a buisiness. So I am guessing the PF doesn't have recomended doctors like your sister organization APEC? I really can't understand it. They are recomended because they are good! APEC wouldn't do this otherwise. How is anyone supposed to find a decent Doc in the US then?

Helen

www.pre-eclampsia.co.uk
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Re : england

Postby laura » Tue Apr 26, 2005 02:22 pm

You're exactly right- we can't recommend docs at all, which is hard because I know many of us feel really strongly about our doctors and would love to share the info. I don't think naming docs from the UK is as big a deal as it is here, because of the differences in how the systems work, but we just have to be consistent across the board.

We just encourage people to email each other with their experiences privately- that way there's no need for us to serve as middleman. Still, even if we could recommend specific doctors, many of the doctors-- even on our medical board- take drastically different approaches on how to approach preeclampsia- anti-coagulation or no? antihypertensives or no? early delivery or no? I don't think there is a one size fits all doctor for all women, so our docs recommend a preconception counseling session to make sure that your goals for the pregnancy and the doctor's route to treatment work well together.
Also, I don't think it is a big a problem as it might seem because of the way our health insurance works-- most of us with health insurance are limited in who we can see by our insurance providers. With the costs of health care these days, most people don't see docs off their list unless there is a very good reason.

If someone is looking for a doctor, we refer them to the http://www.nasshp.org website to find specialists who focus on hypertensive disorders of pregnancy, that can help narrow the field a bit... I'm sorry that this is such a disappointment for you, but different countries/different health systems/ different policies seems inevitable to me...

Laura
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Re : england

Postby denise » Tue Apr 26, 2005 03:08 pm

Great point on the insurance Laura. A woman's health insurance may not allow her to see a particular doctor and she may have to pay for the visits entirely herself or at an out-of-network cost, which is costly too. It's unfortunate that things work that way, but it's the way things are currently.

We have many members who have emailed an individual privately and that option is always available for those who accept emails. I agree that there is such a varying approach to preeclampsia and how it is handled by doctors, that it is difficult to have one recommended doctor or practice.

We value our members and their ideas. I feel the people here are very supportive and are a wealth of information. Just my two cents.

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Re : england

Postby catherine » Tue Apr 26, 2005 03:24 pm

Helen, I've a question. Do you have a strong sense of the extent to which British pre-eclampsia patients access higher levels of care? Obviously the US system has the insurance issue and the access issue. I'm fortunate to be well insured through my work. However, in the state in which I live, geographically large and relatively sparsely populated, there are only 5 board-certified MFM specialists. Fortunately for myself and my daughter, 4 practice at the hospital at which I delivered. They also (academic medics, they hold appointments at the medical school here) work within a state-wide referral system intended to assist OBs or family care physicians who are providing care to pregnant women. They will to teleconferencing etc. How does it work in the UK? Do you attend a high-risk clinic and see whoever is consulting that day? I'm Irish and so relatively familiar with a nationalized medical system and I know that my sister was basically attending clinics and only occasionally seeing a consultant. She wasn't high risk in any of her pregnancies though.

I think it would be interesting for us to understand these issues also because it might help us figure out what are the best ways to share information and ideas for education etc. Oddly enough, the internet has proven to be the best way for those of us who live here in AR to actually hook up and support each other.... that and the fact that there is probably only one best place for a pregnant woman with preeclampsia and her baby !!

Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
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Re : england

Postby helenw » Tue Apr 26, 2005 04:15 pm

Hi catherine. Usually you are seen first by your GP. Many women go thru pregnancy only ever being cared for by the GP and a comunity midwife. But if things start to go wrong you are refered by your GP to an OB at the local hosp. So that is down to who your GP thinks is best. Of course you can request to change to a different Ob. But of course, we put our trust in them.

In my first pregancy & experience of PE I saw an Ob who didn't really seem to know what was what. Mishandled the whole thing. I saw him about 75% of the appointments I had. It was after that I requested to see the APEC doc in london for a pre pregnancy counciling appointment. It was then I started to get assertive, got involved with APEC and started doing stuff for them, and set up my PE website.

When I fell pregnant with my second child, I talked to a midwife at the hosp. She was also a memembr of APEC and I asked her recomendation. (APEC have training days just for midwives and that is such a good idea as they are right in the middle of the care) The OB she recomended was brilliant. Well up on PE. He would only see me, he wouldn't hear of another doctor taking the appointment, and one of the times I was admited he made a point of coming to see me. Also when I turned up at the hosp, not to well, he came to see me straight from surgery. He still had his little white wellie boots on even! And of course he was there for the section. So I saw him for my 3rd child also.

So I think it is pot luck who you see as an Ob. I am a strong believer of educating women so they are aware of the standard of care they are getting, and what to watch out for signs/symtoms, and if they are not happy with it, then to do something about it! The hospitals here are always close, but I guess thats because we are a squashed up country! There is the option of going private and paying for your care, but the hospitals are sparse, and I understand the docs are the same! But once you are under a docs care, you generally stay with him unless you request otherwise.

I think at the hosp they thought I was a trouble maker, but only because I pushed the PE thing, posters, leaflets and such. For some reason they don't want the women to know the signs and symtoms, because they might get scared. In my first pregnancy, the first time I was adnited to hosp with PE I asked about PE as I knew nothing. I was told not to worry, there was no danger to me, if there was any anger it was to the baby. What a statement! Firstly, yes I was in danger, secondly I was supposed to not worry, the danger was only to the baby??!! Unfortunatly I dont drive and have now divorced. So I lost my lift to the hosp, where I used to set up info stands and talk to patients waiting to see the Obs.

I am sorry for spelling mistakes here, its very late here in the UK and I should be asleep! Hope I didn't waffle on to much

Helen

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Re : england

Postby catherine » Tue Apr 26, 2005 07:10 pm

No, not at all, that's fascinating. The business about "not scaring" pregnant women is something that makes me insane. I really don't understand the attitude. I guess some of your blood is circulating through your placenta... but it's still going to your brain. I can't stand the "voodoo" garbage.... "don't dye your hair, don't drink caffinated beverages, you'll never have a healthy bonded relationship with your baby if you don't nurse within moments of delivery (all natural)"..... it's ridiculous that every baby magazine and website touts this garbage when it should really be saying to every pregnant woman.. "do you know what your BP is.... and do you know what it was before you got pregnant?". I'd be pretty happy with... "worry less about stretch marks and more about protein in your pee" also.

Catherine
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Re : england

Postby twinqtsdad » Wed Apr 27, 2005 06:42 am

I want so much to add to this but don't know where to start. The nasshp should be given with a disclaimer also. It may be nonprofit, but that doesn't mean the its,, IMHO,, that its not bias. The Bylaws scare me, but then again its the best we can deal with at the moment.
I think of whats going on here in Naperville, Il. The folks in Naperville have got One of the best school systems going. Now they want to do the same with there hospitals. Naperville's (name not to be mentioned, Like voldermort in harry potter so i will use voldermort now in its place.) Voldermort hospital use to be very poor in the standard of care, but it has been built up to now be one of the best Hospitals around. So because Naperville has grown, they want to build another hospital on the other end of town with the same "best" plan. The problem is the Hospital asso. doesn't want it. The asso. is afraid it will take patients away from the other hospitals surronding Naperville. So Voldermort dropped out of the asso. (run by Dr's,. who are concerned about the best intrest of the patients) So It can build its new Hospital.
Did anyone see the 60 minutes episode about patients going to India for health care? Will moms be "vacationing" in india soon for delivery of there babies, will they still be US citizens? OK I gotto stop before i get all fired up again.
Yours Twolly, Twinqtsdad
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Re : england

Postby laura » Wed Apr 27, 2005 10:33 am

It saddens me that there is so much bureaucracy and red tape interfering with the ability to match one patient with one appropriate doctor.

As a beneficiary of the Indian Health Service, I've had it both ways, as a patient in a private facility and as a more socialized care system. I'm torn. I still use IHS for routine stuff, but if it looks at all complicated I seek a private second opinion. I feel fortunate to have access to both, but I'm not sure I'd come out strongly for either. As with anything else there are costs and benefits...

Laura
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Re : england

Postby akemt » Wed Apr 27, 2005 05:30 pm

I have another question...are the titles of OB and midwife in England similar to those in the US? Did that make sense?

Catherine (24), Moderator
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Re : england

Postby fiona » Wed Apr 27, 2005 09:04 pm

Yes Catherine, to both questions. Although I had never heard of perinatologists before I came to PF and moved to Canada.

So Captain, have I been letting myself go grey these past months for nothing????



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