Struck Off by the General Practitioner
I've learned something new about NHS practice. Patients can be removed from their GP's register, leaving them effectively without health care! The NHS actually works similarly to a managed care plan. People have to sign up with a GP practice in the same postcode as their place of residence. This is not unlike having to sign up with a primary care physician in the States. The general practitioner then, in theory, coordinates all the care that person receives. Just like an American HMO, GPs make more money if they refer people less often to other services, which they have to pay for. Note, every time I see a patient, it comes out of the budget of that patient's GP.
I've mentioned before that I am amazed more people don't challenge their GPs. People here are not educated consumers (for the most part) and still hold the idea that "Doctor knows best." Now I know why. If a GP sees you as being argumentative or confrontational, he can remove you from his register. And not only the person perceived as problematic, but the rest of the family as well!
As the health changes move forward and put even more power into the hands of the GPs, I am concerned about the oversight of that power. As people become more educated and aware of health risks and potential treatments, will they be able to have meaningful conversations with their GPs? I had a lady today who really needed ongoing PT after an acute presentation. I asked her if she had asked her GP for a referral. She was adamant that she couldn't and didn't want me to "bother" him either. I assured her that I wouldn't bother him and she consented to have me call him. He was perfectly fine with providing a referral and was pleased to have my input. I wonder what had happened to this woman in the past to make her so frightened of talking to her GP?
Here is a recent article about the issue.