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[Lico]

 
Hello,

I used to follow these boards for many years (I am 65) when I started HRT under the supervision of Prof. Stubbs at the London menopause clinic. Thank you for all your support and for sharing your experiences and knowledge.

 I was diagnosed with osteopenia in 2016 by Stubbs so am on HRT mainly  for bone health. My protocol was 3 pumps estrogel and 7 days 100mg Utrogestan. My yearly check ups were fine, lining always between 3mmn and 5 mm, bloods were fine, bone density went up. Anxiety, low energy,  low moods were always an issue so he added Testim which I applied rather sporadically! He suggested 4 pumps which I never did ..(was scared to become dependent-stupid of me). I was also diagnosed with vaginal Lichen Sclerosus in 2016 so I am having yearly check up privately for this too (another saga-GP thought that it was allergy ).

Fast forward a few years, Prof.Stubbs retired. Saw another gentleman at the same clinic for a couple of years who told me  to do 10 days Utrogestan instead of 7 days but I got fed up with having to chase up for my blood results and with being told :' nothing to worry about dear' 

So, was recommended privately to a lady-Prof. H- . The first two yearly check ups (10 minutes in duration for £280 each) were rather light weight but she prescribed usual routine blood tests, pelvic scan, Ovestrim for an urehtra caruncle and renewed prescription. No much listening but prefers me to summarize briefly whilst she types away my summary! She then emails me my own summary;  in effect, my consultation is my typed up verbal summary for which I have to pay! 

Last year, I had to chase up for my blood results and do my own interpretation. One test result was missing. Yesterday, I went for my yearly check up and told her about my lack of sleeping, anxiety, family stress, weeing a lot, achy muscles and the beginning of a Bowen lesion near my genitals that had been completely missed by GP and this private Prof. dermatogist ! 

Anyway, the Prof. asked me to be brief as I gave too much information and she could not type up so quickly . She did not perform a physical check up to assess the caruncle for which she gave me Ovestrim treatment the previous year; did not prescribe the usual routine blood tests, nor a smear (HPV is linked with Bowen), nor a bone density scan (main reason for my HRT); nor did she comment on my recent symptoms;  nor read last year medical notes which she typed up.

However, she lectured me  about the new guidelines about me having to take progesterone on a daily basis . Wanted me to have a Mirena coil and patches instead of gel without explaining the reasons behind it. I was quite incensed when I left her cabinet because I could not understand her wanting to change my protocol without blood tests or scan, urine test, without having read my previous medical notes and without checking me out physically following my new symptoms (many ladies on these boards have similar).

All in all, it was a very costly way of renewing a prescription !! I am now looking for somebody else who prescribes a similar protocol to London Menopause Clinic with tweaks following  tests results, does not bang on the guidelines and delves a bit more into the patient's medical history before prescribing blindly. Am I asking too much?? :(I have heard about Beverley Benster? Do you know this lady? Could you recommend someone? (Central London). Any advice?  Do you have similar experiences with private consultants? Apologies for my rant and lengthy post? But I find that some consultants take advantage and are just interested in raking up money..I just wish GPs were more clued up and not at the mercy of budgets..

Thank you very much

[Jules]

Though it was for a different thing, I concur about private medicine.  Had consultation recently and not impressed.  Clearly not up to the standard of one's I've had in the past. It was his manner rather than his expertise,  like I was wasting time. I got the bill 3 days later though!!

[bombsh3ll]

I agree that it's one thing getting patchy care on the NHS, but even more annoying getting a rushed and dismissive consultation and leaving without your needs addressed when paying for care.

I can't recommend a specific clinic but would just add that at least some of the things you need should be available through the NHS such as basic blood tests, DEXA scan, smear test, assessment/referral for skin lesion, and vaginal estrogen on a repeat prescription.

This may then enable you to see a menopause specialist online so you are not limited to the offerings in one part of the country.

There are also lots of places you can get a standalone pelvic scan privately without a consultation.

[Lico]

Hi Jule, not bad. My appointment was yesterday pm; got the bill (£280) this morning at 11h00!!!   Will you see someone else?

[Lico]

Thank you very much
Unfortunately my GP, limited by  budgets, did not want to refer me for a biopsy for my small lesion.  According to him, it was an 'allergy!'. Went to a private Dermatologist who also works for NHS. She was not sure what it was so gave me some cream for allergy. So went to see another private Dermatologist who diagnosed Bowen straight away and performed a biopsy on day of visit- excision on 07 October .

Will have to investigate these menopause specialists online. Any advice?
I agree that there is a huge gap in skillset and we should not have to rely on private practice. Many of the private consultants work in the NHS. Incidently, I find the NHS website very good ..

[AngelaH]

Do you have similar experiences with private consultants?

I had a couple of private appointments, completely waste of my time and money. Probably because I didn’t asked for Testosterone or 5+ pumps of Estrogel to be prescribed, so they really didn’t know what to do with me. 

[AngelaH]

Many of the private consultants work in the NHS. Incidently, I find the NHS website very good ..

Of course and their knowledge is the same, the difference is that privately they charge you for questioning you and for getting answers from you. 

[Kathleen]

Hello ladies.

My experience of a private meno clinic was so disappointing that I am now back with my GP surgery. Initially I became a private patient because I had just restarted HRT as COVID hit and the country went into lockdown. The private clinic was offering consultations via Zoom so I signed up.

I saw three different doctors and  not one of them read my notes beforehand, they had no opinions on my other medications and when I asked about the impact of a drug I take the doctor just said' I only do the hormones '. I realise that she couldn't prescribe outside of her remit but surely she could have offered an opinion. They also failed to listen and I spent a lot of time repeating myself. The last straw was when the doctor emailed me after my appointment to say that I should try using my testosterone at a different time of day as this may help, an odd thing to suggest as I had just told her that I no longer use T. All of these doctors left the clinic after a year so perhaps the job wasn't as fulfilling or lucrative as they had hoped.

The Nurse Practitioner at my surgery is doing a much better job and my care is now coordinated with my GP.

I am sorry that I can't offer any useful information or advice and I am not sure what the solution is. Sadly it appears that finding the right treatment is difficult no matter who you speak to.

Take care ladies.

K.

[CLKD]

Sad these reports as I would expect patients to be given more time when paying for the privilege.  Certainly the breast surgeon who took over from the one who did my operations in the 1990s wasn't 'up to scratch' in my opinion.  Very abrupt.  "Why R U here?"  After being told my worries there was a sigh and "I'll do an ultra sound " as though it really wasn't necessary  .

Fortunately I haven't required to return and hopefully he will have retired if I need to do so!  Some Consultants seem to carry their bed-side manner into private practice, many will be part-time in the NHS due to Contractural restraints.  Others I have seen have been what I expect!

And there are those who simply should not be medics!!! 

[Jules]

Hi Jule, not bad. My appointment was yesterday pm; got the bill (£280) this morning at 11h00!!!   Will you see someone else?

No I feel Ive got my answers via him and my GP but considering Id waited 6 months for my results and had to write 3 times and then got a letter with the conclusion and no explanation unless I paid for an appointment, it's a bit rich being billed in 3 days. I wondered whether to wait 6 months and until he had asked 3 times before I paid

[Kathleen]

Hello again ladies.

Jules - I like your style!

How about refund system, a sort of '  money back if not entirely satisfied ' arrangement!

Take care.

K.

[Lico]

this would be a great idea!

[Jules]

I did think I might get a discount considering but no chance.

[getting_old]

From reading your post I was surprised you returned this year. From the doctor's point of view because you keep returning then she assumes you've been happy with the way she's handled the previous appointments and therefore she has no reason to change. Personally I would have given her a second chance, but at the second appointment I would have taken a list of questions and asked her to stop typing and actually answer them.
It sounds like the service they are offering is purely a medication refill, and not a proper health review. You'll probably find they have some sort of daily target for number of patients, prescriptions, etc Sad really