Question re combined care scheme GP visits

Leelee111

Hi all,
I am 25 weeks pregnant and part of the combined care/domino scheme between the rotunda hospital and my GP. So far every Gp checkup has been with the nurse in the practice rather than the doctor. The nurse is excellent and I haven't had an issue with her care, but when I specifically requested to see the doctor to discuss and complete my paperwork for maternity benefit, I was told the doctor 'doesn't do antenatal visits'. The receptionist has been very unwilling to put me in contact with the doctor for pregnancy issues at all. She hasn't been available to me for consultation, in person or even on the phone. They will only allow me to see the nurse. Is this standard practice? It's my first baby so I didn't really know what to expect but I find it frustrating that I have not seen the doctor for the duration of my pregnancy to date. I am looking into changing GPs as a result but I imagine there's a lot of paperwork involved to transfer files for this scheme, as well as the hassle of starting from scratch with a new GP at this stage in my pregnancy.
I hope some other mums out there can shed some light for me!
Thanks!

2xj3hplqgsbkym

Wow, that gp sounds pretty bad. I never saw a nurse at my gps on my 3 pregnancies. I would ring the HSE and see is that even allowed.
Although I am sure you are fine and the nurse or midwife would pick up on any problems just as well as a doctor, it is nice to see the doctor too for reassurance.
I would definitely try to change doctors, it's not like you have a rapport with this one anyway as you don't even see her.

irishgirl19

I would ring the surgery and just ask to make an appointment for the doctor, don't mention anything about antenatal. It will be covered under the scheme anyway so you won't pay.
My gp is like this too , the 'midwife' they book me in with hadn't a clue when I asked her about eating certain foods etc.
I just attend the gynae who helped me get pregnant for all my visits now

bovril

Hi OP, I switched GP during combined care. I had a thread going here at the time.
http://www.boards.ie/vbulletin/showthread.php?t=2057330467

The HSE are very helpful if you ring so maybe that's the first thing you should do and mention your situation with not seeing your GP. While I can see a lot of the things they check at each visit being OK for the nurse to check, there are some things the GP should be doing e.g deciding on the BP readings and if you have any concerns you should be able to ask the GP.

January

irishgirl19 wrote: »

I would ring the surgery and just ask to make an appointment for the doctor, don't mention anything about antenatal. It will be covered under the scheme anyway so you won't pay.
My gp is like this too , the 'midwife' they book me in with hadn't a clue when I asked her about eating certain foods etc.
I just attend the gynae who helped me get pregnant for all my visits now

There are only a certain amount of antenatal visits available under combined care.

It is perfectly normal not to see the doctor during your pregnancy and it indicates that you are having a very healthy pregnancy.

lazygal

January wrote: »

There are only a certain amount of antenatal visits available under combined care.

It is perfectly normal not to see the doctor during your pregnancy and it indicates that you are having a very healthy pregnancy.

The HSE is paying for a GP though, not a nurse. I didn't do combined care but I'd expect to see a doctor rather than a nurse as that's what combined care is supposed to involve. If I book in with a GP for anything else I expect them to deal with the appointment not a nurse.

Diamond Doll

I did combined care and the GP practice had a nurse who did all of the antenatal care visits. I didn't mind because she was very knowledgeable, really took her time with the visits, and gave me good advice. The one time I did have an issue (I had a bit of a chest infection and was coughing up a bit of blood) she brought in the GP straight away to examine me.

However if - for whatever reason - I wanted to see the GP at every visit, I would fully expect this to be done. As mentioned above, the HSE are paying for a GP, not a nurse.

If I were to go again, I'd go public but go with hospital only rather than combined care. Purely for consistency of care, and for convenience. I would have done this last time if I'd known it was an option, I thought at the time that you had to do combined care if on the public system.

irishgirl19

Once the op doesn't exceed the visit amounts she should be fine.
Its very annoying situation.
I didn't know that combined care was an option.
I've only went to my own doctors about 3 times (seen by midwife/nurse) since finding out I was pregnant so I hope I'm still covered for the free baby check ups etc once baby arrives

Leelee111

Thanks all, good to hear some experienced mums advice on this! The nurse has been great, but like many of you said, they're being paid for GP care, not nurse care. And when a patient specifically requests to see the doctor and is refused, I'm just not comfortable with that. I'll call the HSE tomorrow about it for clarification. Hopefully it's not too much of a paperwork mountain to change GPs at this stage!

January

Definitely give the HSE a call but as far as I'm concerned the nurse is doing the exact same job the doctor is going to do... I never did combined care on any of my children but I would have had no problem seeing the nurse if I had done.

They're part of your antenatal check ups, they're not there to be used for normal doctor appointments.

mirrorwall14

Leelee111 wrote: »

Thanks all, good to hear some experienced mums advice on this! The nurse has been great, but like many of you said, they're being paid for GP care, not nurse care. And when a patient specifically requests to see the doctor and is refused, I'm just not comfortable with that. I'll call the HSE tomorrow about it for clarification. Hopefully it's not too much of a paperwork mountain to change GPs at this stage!

Let us know what they say, I'd be curious to know if you don't mind!

cruais

How many visits are we entitled to? Is it 6 while pregnant?

irishgirl19

cruais wrote:

How many visits are we entitled to? Is it 6 while pregnant?

0-28 weeks visit every 4 weeks
28-36weeks visit every 2 weeks
36 to delivery visit every week

Visit for baby 2 weeks after delivery
6 week examination for yourself and your baby

Leogirl

My GP does the same but then sometimes, it has been the doctor I've seen. I rang today to make my 32 week appointment & they would only put me in with a nurse on Friday. I was told the nurse does ante natal visits but when I gave my name, they offered me GP (I have MS & in special clinic with Holles St). I think if I hadnt MS, they'd insist I see the nurse. I dont mind because shes very good but shes not the doctor, if I felt I needed a doctor I would insist on it.

bovril

irishgirl19 wrote: »

0-28 weeks visit every 4 weeks
28-36weeks visit every 2 weeks
36 to delivery visit every week

Visit for baby 2 weeks after delivery
6 week examination for yourself and your baby

From the HSE link it says the visits mentioned in quoted post are alternating with hospital visits and you are due 5 visits but are entitled to more if you have high blood pressure or diabetes.
Link here
http://www.hse.ie/eng/services/list/3/maternity/combinedcare.html

Leelee111

Ok so the latest update is; I went back to the Surgery, doctor wasn't there so once again could only talk to the receptionist! I explained how I felt the 'doctor doesn't do antenatal' wasn't good enough, particularly given the complications in my pregnancy to date (without too much detail, there's been a miscarriage of one twin and an umbilical cord issue so far). Throughout my rant, she just responded 'yeah', and when I said I would be changing GP she just said ok , thanks, bye! I haven't called the HSE yet as I wanted to ensure the changeover to a new GP went smoothly first so that part is to be continued!

pooch90

Wow, I would be absolutely fuming if I were you!!! So far I've had two check ups at GP,the one this week my GP was away but they still sent me to a doctor even though they just did BP,urine and measure Tummy.

lazygal

That GP sounds really cheeky. Doesn't do antenatal, indeed! Then why bother with the HSE scheme of combined care at all, then?

ShaShaBear

I'm getting combined care with my current pregnancy and did with my last one too. I never, ever saw a nurse on any of my GP antenatal visits. Ever. And the midwives made it clear that I was to see my GP.