Sunday, 3 July 2016

Why I 'sacked' my physiotherapist

I had suffered intermittent pain for several months. When the pain became more frequent and I was finding it increasingly difficult to do the things I used to be able to do, I went to see my GP.

The GP knows I don't usually kachow him unless I really needed to. I was referred immediately to physiotherapy, as I hoped.

It was several weeks later before I was called by a private physiotherapy service (APS) to make an appointment. I assumed that the NHS physiotherapy service was overwhelmed and they had to farm out services to the private sector.

Fine, so long as I am not paying for this privately. Saw the physio a month after I saw the GP.

The GP had given me the impression that I was 'entitled' to six sessions. The physio (VS) told me I had five. OK. I was not going to argue.

What was my problem? After lots of questions and testing for range of movement and muscle strength VS told me I was suffering from 'inflammation of muscle/s'. This has restricted the movement of the joint thereby causing the pain. Or maybe it's the other way around.

He demonstrated the exercises that I should do (pendulum swings, wall presses, etc) and gave me printouts on exercises to do.

I said, "Is this it?"

"O yes, physio appointments are usually 15-20 minutes."

(It takes me half an hour to get to the clinic and another half an hour to get back.)

Why then did the GP tell me to take co-codamol before appointment in anticipation of pain, I wondered, but did not say anything.

So many friends and colleagues seem to have had, or known someone who has had, frozen shoulder. I was asked repeatedly, "Is it a frozen shoulder?"

The next session I asked VS, directly, "Is it a frozen shoulder?"

He said it was not a frozen shoulder. What is it then? He refused to tell me in simple English. To paraphrase: It could be this. It could be that.

By this time I was in a lot of pain, much more than when I first started physio! Pain was constant. Sleep was difficult. My movement was getting even more restricted. Writing by hand was too painful. I could not even sign my name! I had to stop some of my voluntary work as a result. I was suffering spasms in my right hand making me fearful about driving. I was dropping and breaking stuff because I had lost so much muscle strength in my right arm.

I had three other sessions. Each time he would start by asking how I thought I was doing, was I any better followed by "Any questions?". Then he would 'test' to see how well I was doing my exercises, pointing out if I did those wrong. Each time he gave me new exercises and more printouts. I had to do Set A three times a day, Set B two times a day, and Set C once a day. You get the picture.

The last session was a bit weird.

Earlier that day, I was teaching a class of old people how to use the laptop. One student was late. I helped her to remove her polyester coat. I felt static and I jumped. That sudden jerky movement caused me to double over in pain. The rest of the class looked on in horror as I took minutes to recover. (One was a retired nurse, so I would have been OK.)

VS applied ultra-sound which was supposed to relieve me of the pain. It did not. This was the only time he performed any 'therapy' on me.

He spent much of the time at the beginning of the session talking about being 'signed off' because I had finished my fifth and last session. I could continue as a private patient paying £42 a session. I could go back to the GP to ask him to refer again. Or VS could 'change the numbers' and I could have three more sessions.

Surely 'changing the numbers' = 'creative accounting'? The taxpayer is supposed to have paid for five sessions of physio treatment. Why would this private company provide three more 'for free'?

It suggests to me that this company (APS) was mis/representing itself as providing 'five sessions' and hoped to get away with 'five sessions of 15-20 minutes' when the taxpayer is paying for 5x30 minutes (150 minutes). Unfortunately I am a stubborn patient and they have to do a little bit more. Having been seen for 5 x 18-minute sessions (on an average), I am still 'being owed' 60 minutes, equivalent to about 20 minutes each.

I opted to have another three sessions.

But I also returned to the GP as there was no real improvement. By this time I was feeling quite anxious as to what could be the cause. VS said my spasms had nothing to do with the shoulder as 'nothing' connects my shoulder to my fingers (!!). I was mystified by this statement.  He also hinted that surgery might be an option, in which case I needed an orthopaedic who specializes in upper limbs.

To cut a long story short:
(1) GP requested X-ray and referred me to a specialist (this was at the end of April).
(2) X-ray showed minimal wear-and-tear.
(3) VS gave me three additional sessions during which he actually manipulated my arm and shoulder causing some pain. The irony was I felt better for it. I was signed off again.
(4) Finally, in mid-June, saw a specialist (JK) who quickly diagnosed frozen shoulder. He would refer for more physio (hopefully not with VS's company, but he could not actually designate), ultra-sound scan and steroid jab.
(5) Returned to GP to tell him I had lost all faith in VS. Please refer to a different one, which he did.

After seeing the specialist (4, above) I was relieved but very angry. I have lived in distress and anxiety for more than four months thinking that something sinister was happening to me and that I might require complex surgery under general anaesthetic. It was merely a frozen shoulder, which would eventually unfreeze.

So I sacked VS. The specialist JK's referral for further physiotherapy resulted in my being sent back to VS's company (APS). I refused to go back. I am now paying for private physiotherapy at another private provider recommended to me by a fellow gym member.

Incidentally I could have been assigned to this new provider (PL) in the first place on the NHS under the 'choose and book scheme'. For some reason I was not given this choice. Instead I was simply told to attend APS. It caused me to wonder if there is a bit of corruption going on in that someone was sending NHS patients to a certain private practice despite it not being the one closest to where the patient lives. That 'someone' is also depriving patients the chance to 'choose and book'.

It is possible that my husband's private medical insurance might cover this new physio. Even then, there is an excess to pay. Speaking to the receptionist at the PL practice, I have confirmation that the GP practice has referred (the second time) to this same private physiotherapy service as requested. But there are -- wait for this -- 300 people on the waiting list. It would take eight to ten weeks for me to get to the top of the list if I did not have the resources to pay.

Such is the beauty of an 'all-free' NHS which our taxes have, ostensibly, already paid for.

My new physio RP is great. He causes me a lot of pain but I can see almost immediate improvement in my range of movement and for that, I can only be thankful.

Still it is going to be a long time before I can get rid of the bingo wings that have developed as a result of my not being able to exercise those muscles.

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