It’s certainly true that in the US, the medical profession encourages patients to become involved with their own care – they get a bit stroppy if you act disinterested or uninvolved. Not unlike the aircraft maintenance profession in the US, there is a definite parallel 
It’s apparent to me from interaction with German and U.K. based relatives that their level of involvement with their own care is much less and frankly they strike me as uninformed, not caring whether they get what I consider basic care, for example the routine colonoscopy at 50 or tracking PSA. They are (in general) relatively complacent, for example some of them act a bit shocked and surprised when I ask “at what age do you think smoking is going to kill you”? In the US, smoking among anybody with a brain is long since gone. Whatever, it’s their life but the culture of personal responsibility in medical care among middle class, otherwise clued-in people is regardless noticeably different.
I don’t have one doctor, I have a very experienced 70+ year old South African educated GP I like a lot, at a clinic that attracts patients from around the world, plus any other doctor I want to see at any time, anywhere with no prior approval required by the insurance scheme I selected. I listen to experts but don’t let any one of them totally force my opinion. What others may think of that, regardless of who they are, is of no particular interest or concern to me although I do think the aforementioned GP has his head screwed on pretty well based on me asking a lot of questions at e.g. my annual physician, selecting and discussing/interpreting blood tests etc.
The main thing I’m working on now, as it happens, is low density cholesterol and I’m pretty happy to have found I can tailor my diet to control it. When and if the time comes for cholesterol medication (I have relevant family history on my mother’s side) I will have read a lot and iteratively discussed it with two or more doctors before deciding on the best course.
Rwy20 wrote:
I really wouldn’t put blind trust in your doctor,
DavidJ wrote:
Use all available means to stay informed, of course. Who would argue with that?
kwlf wrote:
The easiest way to get a good rating is to give patients what they want, the easiest way to get a bad rating is not to give patients what they want. The patients who are most satisfied with their doctors are apparently more likely to die
I couldn’t have put it better.
Silvaire wrote:
plus any other doctor I want to see at any time, anywhere with no prior approval required by the insurance scheme I selected
Here in the UK it simply would not be possible because of the total stranglehold a GP has on a patient seeing anyone further up the chain without a GP referral. That applies to our public health service as well as private medicine. Why that is I do not know but no doubt someone will be able to tell us (and I fully expect money will be involved somewhere). I wish it were not so.
Lots of the more pro-active people complain about this system.
There may be a specific reason with the way responsibility is structured in the NHS but it looks like it is set up that way to make sure consultants don’t get too many members of the public bothering them i.e. the GP acts as a “filter”.
In some scenarios you can pretty well book yourself directly in with a private consultant and his office will simply tell your GP to fax over an authorisation i.e. a fait accompli. The GP is normally quite happy to have one less appointment. The consultant will then write periodic letters to your GP as a courtesy to keep him informed.
With an NHS (i.e. non private) consultant it probably won’t work but it doesn’t matter because the wait for the GP appointment (say 1 week, often less) is likely to be insignificant compared to the wait for the consultant (easily 12 weeks).
But it depends on what it is, obviously. The NHS treats certain categories very seriously. However, the typical scenario in UK hospitals is that if they see you can walk and there is nothing obviously wrong they prefer to send you back home, until you tell them you are a “pilot” and then all hell breaks loose and you get great service. Presumably Plan B would be to mention the word “Germanwings” but I am not aware of anyone needing to do that.
Peter wrote:
But it depends on what it is, obviously. The NHS treats certain categories very seriously. However, the typical scenario in UK hospitals is that if they see you can walk and there is nothing obviously wrong they prefer to send you back home, until you tell them you are a “pilot” and then all hell breaks loose and you get great service. Presumably Plan B would be to mention the word “Germanwings” but I am not aware of anyone needing to do that.
Isn’t a greater risk them suspending your medical? I’d be a bit scared of it backfiring that way.
In at least France and Portugal, knowing a doctor (even if junior), or someone that is friends with the clinic director will help immensely. Suddenly, everything happens much much faster and with more attention.
Well, under Part M your medical is dead anyway (until an AME review, and probably a CAA review) in most relevant scenarios. So if you need tests done you may as well use that method. The CAA will ask for tests and consultant reports in many cases anyway and the cost of these (can be thousands) stops some people flying, just due to the expense.
Peter wrote:
Well, under Part M your medical is dead anyway
Would you please be kind enough to explain this? I assume you refer to the self certification bit but as I understand it this is only acceptable in the UK and nowhere else. What I have misunderstood please?
The fact is today, the way medicals are done and how the FAA treats you, is that you need to keep extremely vigilant about going to your regular GP. Anything out of the ordinary and you’re looking at special issuance, months of referrals and grounding. It’s a sad fact that the less they know, and the less you go to a doctor, the better you are off. Which is completely opposite of how it should be. But that’s how it is.
It’s apparent to me from interaction with German and U.K. based relatives that their level of involvement with their own care is much less and frankly they strike me as uninformed, not caring whether they get what I consider basic care, for example the routine colonoscopy at 50 or tracking PSA.
Its a fair point, not sure why the medical establishment takes a more sanguine or conservative view on these tests in Europe. Your GP will run a PSA blood test for you, but only if you request it. Not sure you can get a colonoscopy on the NHS, but probably your GP can arrange it. Perhaps in a socialised medical framework they decided universal testing on these conditions would not be cost effective?
The article below had some interesting questions – whether Europe is better due to life style, or state provision is not clear.
