I think this (rubber stamping) is not what I said or recommended, Adrian.

I said that the decision for a private referral should validly be based
on whether someone requires a doctor with expertise in the area. Whether
I can provide that expertise personally or not, is irrelevant.  The fact
that someone asks for a private referral means that s/he is exercising a
choice where they get their (private) medical opinion from. I do not
think it is right or proper to stand in the way of that - unless there
are no medical reasons of any kind to see a doctor or the opinion sought
is not one I would trust - and hence want no part in it.

The matter of gate keeping is specifically part of the NHS GP's role, is
generally accepted by the (majority of the) tax paying public and is
part of the national concordate, including our  nGMS contract. It is
simply not part of our role as a private GP and creates unnecessary
aggro if assumed. I think it is also worthwhile pointing this out to
anyone who dreams of a privatised health service, but that is outside of
this debate..

Wrt BUPA forms I see very few, in fact I remember having seen only 2 or
3 in the last 3 years despite an abundance of private involvement with
some of my patients. And, yes, one could and should  alter any form
until it says what one would be happy to sign.

So, "this patient wants to see you, a private physiotherapist" - yes.
"This patient required a physiotherapist opinion and treatment, because
I did not know what to do with him" - no.

Peter

Midgley wrote:
> Peter von Kaehne wrote:
>> That is not my of concern TBH.
>>
>>   
> Another and more general point is the question of what one is invited
> to sign.  An argument later over not completing a form for BUPA
> without crossing out the bit about "necessary" in the referral may
> lead to more door slamming, and if the fee for completing that is the
> very reasonable £50 it might be argued either than the fee was not for
> considering it but for signing it unaltered regardless, or that the
> service requested had not been performed and the fee should be
> returned.  Unsuccessfully, I hope.
>
>
> Nevertheless, as a doctor one is expected and required to exercise
> more thought over these things than simply as a citizen, and if there
> is no element of professional judgement involved, then steps should be
> taken to ensure that it does not appear to have involved professional
> judgement.
>
> Rubber stamps should be rubber stamps, not doctors.
>


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