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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Tom Twilight on October 8, 2005, at 18:57:32
In reply to Re: Do the British know something we don't?, posted by tecknohed on October 4, 2005, at 19:25:47
Glossary for none UK people:
NHS means "National Health Service"
Alternatively "No Hope Service" or "No Help Sorry"
;)Hey everyone
Unfortunately I've come into the discussion rather late, which is a very annoying because it’s such an interesting one!
Several things that were said in this thread really struck a cord with me.......I think part of problem with the UK is that the NHS is completely publicly funded; therefore there is not the same incentive to please patients as there is in a private system.
NHS docs get paid equally, whether they help patients or not.The UK system is, on the whole, unwieldy and conservative.
Most UK docs seems unwilling to experiment with med combos, and are also unwilling to treat disorders aggressively.
Also the vast majority of UK GPs and Psychiatrists seem to be quite benzo phobic.I work in Addenbrook’s Hospital Cambridge as a porter
Supposedly one of top UK NHS hospitals, as yet I haven’t had any involvement with the psychiatric side of things.
I will say that although it very impressive in some respects, it does seem to be lacking in others, the pain control particularly seems to be quite lackadaisical, and the lifts frequently brake downI'd also like to say that Tecknohead's post really struck a cord with me
> I've had lots of trouble getting what I need from UK docs. Try mentioning Parnate to a UK pdoc and then wait to be laughed at!
The very idea! An MAOI and a Stimulant!
> It seems especially hard for Social Phobics who have limited choice already. Yet for some reason Seroxat or Moclobemide are 'highly' recommended for it. Uh, why?
>
Moclobemide for serious mental illness, what a joke! Treating one the most stubborn disorders with one of the weakest drugs. To his credit my last UK Pdoc said it was useless
Having said that it probably works great for some people, but not very many, I daresay.Someone said that the Australian health system is best
Probably because it a mixture of public and private funding so you get the best of both worlds..........
Posted by tizza on October 8, 2005, at 18:57:32
In reply to The British Medical System-A few thoughts, posted by Tom Twilight on October 7, 2005, at 16:29:12
You're right tom, Australia does have a mixture of both public and private health services, if you have the money and can pay for private health insurance, you can SOMETIMES get better treatment but never discredit our public system, it's quite good too. Our employers don't pay for our medical plans because there is a public one in place already. I see a public GP and a private pdoc, the pdoc is out of my own pocket UNTIL I hit a thing that is called the saftey net which has been established by the government. For example, once I spend $700 dollars within one year I get about 96% back from the government even though it's considered a private service so my private pdoc visits basically don't cost me a cent anymore. The other fact about taking out your own private health insurance is that it costs between $700 to $1000 a year so why bother, but the government is raising the saftey net to $1000 dollars next year. Bloody greedy pigs!!!!!!!!! Also another AMAZING point in the Australian health system that would be very interesting for the people of the US is that there is no drug restrictions for prescriptions depending on what bloody plan you are on. That is why I mentioned earlier I think we get the best of both worlds. I can't believe some of you poor people in the US are restricted to certain drugs because your plan says so, if you need certain meds you should be able to get what the hell you need. Also another point!!!!!!!!!!!!! The majority of our meds are also subsidised by the Aussie gov, so you usually pay less than $20 AUD for a script and there aren't too many meds that aren't on that list. They have made the point of showing you how much it's really worth on the box but have only recently started doing this. Most people have been shocked to find the UGLY truth that pharmacutical companies are some of the greediest businesses in the world, we have been ignorant or left in the dark about this and GUESS WHAT, less drugs each week are being place on that subsidised list. So basically I know how damn lucky we are but times they are a changin'.Paul
Posted by NikkiT2 on October 16, 2005, at 6:32:31
In reply to The British Medical System-A few thoughts, posted by Tom Twilight on October 7, 2005, at 16:29:12
Hi, sorry for a late reply.. But working too hard and less time online for more than the basics of what I read *L*
>I think part of problem with the UK is that the NHS is completely publicly funded;
You do have the option of going privately remember.. Yes, thats expensive, I agree, and wasn't an option for me..
But the other side of it is, if you need treatment, you WILL get it. There is no way at all that I would have been able to have been treated in the US.. I would have simply had to sit back and suffer.. For both my medical and physical problems.
I like that when I was earning *nothing* (but couldn't claim any state benefits because I was still legally employed, and had used up all my SSP) I was still getting treatment and medication at an affordable level. have you thought about how much you pay for your medication over the vast majority of the rest of the world?>The UK system is, on the whole, unwieldy and conservative.
Yes, alot of the psychiatrists are - not the system, but many of the doctors. Getting an advocate is always agood idea, someone who knows how to really work the system, so you can try and change your pdoc
>Most UK docs seems unwilling to experiment with med combos, and are also unwilling to treat disorders aggressively.
Also the vast majority of UK GPs and Psychiatrists seem to be quite benzo phobic.GP's are benzo phobic for a reason. They're highly addictve, and it is, in my opinion, not good to prescribe something to someone and cause an addiction. In the 70's they were much more free with benzo's, but they ended up with large numbers of benzo addicted patients.. Once bitten, twice shy I guess.
Also, there is this thing called "evidence base". Most doctors have a strong belief in working with an evidence base. If you can find a doc that works in research too, he would probably be more willing to work with combo's.
I have to say here though, that I have been shocked by some of the HUGE combo's that some people here are on, and I find that level of medication really un nessesary.
> I've had lots of trouble getting what I need from UK docs. Try mentioning Parnate to a UK pdoc and then wait to be laughed at!In the UK a patient that expresses suicidal urges (whether ideation or simply said they do have a plan) won't be prescribed an MAOI. Or a tricyclic often.
> It seems especially hard for Social Phobics who have limited choice already. Yet for some reason Seroxat or Moclobemide are 'highly' recommended for it. Uh, why?
Theres not real evidence base for any meds working for Social Phobia. The only real evidence base in this area, that works long term, is therapy such as CBT or CAT.
No meds ever touched mine, but CBT worked utter wonders. Have you asked for therapy to help with it?>
Moclobemide for serious mental illness, what a joke! Treating one the most stubborn disorders with one of the weakest drugs. To his credit my last UK Pdoc said it was useless
Having said that it probably works great for some people, but not very many, I daresay.Not quite sure what you're saying here, I don't believe it is a highly prescribed medication.
Someone said that the Australian health system is best
Probably because it a mixture of public and private funding so you get the best of both worlds..........The French system is similar and works incredibly well in my opinion. But, if anything has to be paid "up front" and then claimed back, then you're cancelling out all those people who simply cannot afford to pay up front for things. If that had been the only option for me, then I can quite clearly say I would be dead now.
The UK does work heavily on evidence based medicine in the main stream (ie, non research hospitals).. It has its positives, and it has its negatives..
Nikki xx
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