Demanding to see a consultant

Just wondering if anyone has ever refused to see an intern/resident/registrar and insisted on speaking directly to a consultant with regards to their child's condition in a public hospital. I am planning on doing this at DS1's next appointment and would just like a heads up on what sort of reaction I might expect. Thanks :)

The reaction you will get will depend on a variety of things:

Your reason
How you broach it
The individual receiving this information

Then there is the reaction from the consultant. Most Consultants will be patient and listen to you. Perhaps a little patronizing but shouldn't give you any grief.

Honestly, you might get some hostility but if you go in being diplomatic it should be ok. It will depend on the consultants availability as well. If it's a clinic, they might not be avail. But do expect the "this is a public hospital, you can't pick and chose" speech.

I have requested a consultant before. Actually, I presented to ED via ambulance and asked them to call my consultant who I had seen the day prior. The intern took offense and barely gave me any treatment at all. It took the nurse to see me have another attack (pain) who got the on duty consultant who listened to me and then called my consultant on the mobile immediately.

My advice would be to go in and patiently and calmly explain your reasons for wanting the consultant - take the emotion out of it. Don't make threats (I hear people say "I'll report you!" all the time and it gets them nowhere) but if you are refused a consultant, ask what the process is at THAT venue for escalating the problem as you feel DS requires more experienced care givers. Feel free to contact the patient liaison person to assist you with that too.

Good Luck.

Thanks Mother Goose, that is really helpful :)

My plan was to say to whoever I see (recently it has been mainly interns) that I'm really happy for them to participate in care, but I have a lot of questions that I feel have not really been answered so I would like to see the consultant in charge of his case as I'm feeling a bit confused and disillusioned by his treatment so far. Does that sound fair or should I leave out the disillusioned part? It's not that I will refuse to see anyone else, and I'm happy for them to do the initial assessment, but I would like to at least have some face to face time with the decision maker.

Interns typically take these things harder and more personally than more experienced Drs so be ready!

I think what you have planned is reasonable but I would leave out the disillusioned part.

Would you be happy to speak with the senior registrar? Can I ask what specialty it is? Often the senior registrar (especially at this time of year) has either just sat their consultant exams or are about to.

If you have specific questions you want answered, go in with them written down and ask them. And keep asking until you have an answer you understand and fully answers your question. Don't be afraid to say "Can you please explain that again as I didn't understand/you response has confused me as Dr CBC said XYZ".

yes I would be happy with the senior reg, but TBH I would prefer the consultant as he seems to be the only one who is both willing and able to answer my questions. The interns are willing but not yet experienced enough, and the registrars have so far been unwilling to sit and explain things to me and seem really irritated by my constant questions. I know it is a drawback of sorts having a tiny bit of medical knowledge because I question everything but I can't help it, I almost wish I hadn't started my degree yet!

Lol, don't worry - it's normal to question. I make a dreadful patient ;)

Ask for the consultant but be prepared that you might get the senior reg. If you don't like the level of answers you get from them, tell them you don't feel they are answering your questions and if they don't have the time to do so, could they please make an appointment for you to see the consultant.

If it does get to the point that the reg doesn't willingly answer, let their consultant know when you see them.

ok thanks :)

My first issue will be getting an appointment this week instead of in a fortnight. I've decided the easiest thing will be just to go to outpatients in person and ask about any cancellations. I'm really hoping that the ortho reg I spoke to on Friday wrote a note or something on DS1's notes so that the receptionist is happy to go ahead and change the appointment.

if not, ask them to page the Reg you spoke to and confirm ;)

he never gave me his name, do you think if they just page the on call reg I will be able to get a similar response?

Maybe but it will be a different person this week. But it was probably the on call you spoke to last week and they will have the roster

ok thanks, I will remember your wise words tomorrow morning

Quick update :)

I spoke to outpatients yesterday and they said they couldn't get him an appointment this week but they would get a history review done and someone would call me. Of course nobody did so I spoke to the ortho reg again (different guy) and he said that they would try and get him in for Monday next week and that someone would call me. I declined to hold my breath and contacted a private surgeon about transferring care and am waiting a call back to see if it's possible.

Thirty minutes or so after I called the private surgeon I got a call from the public registrar. A very nice man who actually (and unusually) gave me his name as something other than "one of the doctors" and he asked me to bring DS1 in next Monday as the consultant (a friend and colleague of the private surgeon I contacted) is very keen to review his case. Finally a result! Hopefully they stick to their word and I get to see the consultant so I can have my questions answered and some continuity of care.

Glad you have had a good outcome so far and good luck for your appointment next week. Most doctors do try to do their best in a poorly resourced system. All the advice you've been given so far has been spot on.

Thanks k4t :) I know I sound like a dreadful demanding parent but I am honestly a massive supporter of the public health system, and this is why I initially chose the public system rather than the private system. I'm just at my wits end because DS1 doesn't seem to be improving and everyone is telling me something different. I just want to know that someone is overseeing his case and he doesn't get lost in the system. I'm very worried he will have permanent nerve damage and nobody is listening to my concerns :(

Have you thought about talking to the hospital patient advocate? they can often be a good supporter and can help with any bumps in the system.

I'm not sure how to find the patient advocate. The website says they have a consumer liason, would that be the same person do you think?

It will be the same person Trav. If you call switch, they will put you through.

Glad you've been able to make some progress! Fingers crossed for an appt on Monday! If you haven't heard by 1 on Friday, call out patients back and tell them Dr x said he was going to org an appt for Mon and you were wondering what time to bring DS in. Xo

Every hospital has its own terminology so it might be. Otherwise check with the information desk when you go in to your appointment and they should be able to direct you to the right person.

You don't sound demanding at all Traveller. All your concerns are completely reasonable and you're going about trying to have them answered in a sensible respectful way. The public hospital system can be terrible for continuity of care. Just the nature of rostering and the volume of staff and patients. Maybe suggest to the doctor you see Monday that you would like to feel one doctor is coordinating your DS care and communicating consistently with you. If the same consultant can't see you every time often they'll nominate one of the registrars to be your main point of call as they're often on-site the most consistently if that makes sense.

:thumbsup:

One of the things I have learnt to do over the year when dealing with any institution/beaurocracy is to ask people their names (including their family name) straight up and make a note of it. In my experience people give you better service and provide more help when they know that things are more likely to come back to them.
If they say one of the Doctors ask them to be more specific.

I work within the public health system. I always go private with my kids. I need to know that the one dr knows my child and his/her case... It's very hard to achieve that in the public system. You sound like you are doing the best job you can. I'd agree with you if Monday doesn't work out then go private!

Thanks everyone for your support :-)

Update again :)

Saw a lovely registrar today who, when I asked to speak to the consultant, said yes immediately but offered to answer my questions as much as she could herself first. Then the consultant came in, a plan has been put in place, and I am reassured that if I have questions I can call the lovely registrar instead of whoever answers the phone so no more being fobbed off. Also they have asked us to remain in the public system as it is easier for them to confer with other surgeons, and as the moment his case is being reviewed by a radiologist, a paediatric consultant, an upper limb specialist as well as the orthopaedic surgeon. Should hear by close of day next Monday if he is having other testing done and we have a rough date by which, if there is no improvement, they will act surgically but right now they want to avoid it.

now there's a better outcome. Well done chick.

EXCELLENT! Well done!!!!!!

Glad his care seems to be coming together. Well done for being your ds's advocate :)

Well done!! So happy that you have a plan in place that you are comfortable with.