> QUESTION:
>
> I've got a patient with a worsening, severe sciatica (2 months now), a
> review (Deane M et al The effectiveness of treatments for prolapsed
> lumbar intervetrebral disc: a review of the literature. European Journal
> of Public Health 1996;6:15-20) suggests referral to a surgeon trained to
> perform microdiscectomies;
> HOW do i find the BEST surgeon fairly nearby
> to refer the patient to?
Why not refer him/her to a good surgeon, an adequate surgeon, a kind
surgeon, a local orthopaedic surgeon, an adjective of your choice surgeon?
Is the letter below a taste of things to come?
Dear Mr Localbod,
Re Mr Dos Hurtalot
Many thanks for seeing this 50 year old gentleman with a 2 month history of
increasingly severe sciatica. There has been no response to non steroidal
medication over this time. The patient has sensory loss over the lateral
border of the left foot and has an absent ankle jerk. If you feel that you
are qualified and experienced enough to perform microdiscectomies, then I
would be grateful for your confimation of this diagnosis with suitable
imaging and consideration of this procedure.
Please pass this referral on to any member of your faculty team if after an
appraisal of your internal audit system there is someone more suitable to
give an opinion.
Please feel free to pass this referral on to the regional centre of
excellence of your choice based upon your experience of the best
practitoners in this field. I can confirm that the GPville primary care
group will bear the cost of such further referal.
Yours sincerely
cc
Chair PCG
Community Health Council
Local MP
Minister of state for Health
PCG legal executive
Mr Dos Hurtalot
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