Dear US-type-people, a query

[innocent_lex]

This might seem odd, but I want to get this right. Here in the repubic of olyparalympic-land we have our own doctors (GPs). When we need to get tested for pretty much anything beyond blood tests, we have to make an appointment with a hospital and get it done there. So if I needed an xray I'd have to get it done at a hospital. Is that the same for

Comments

[iamrosalita]

Depends on the doctor. My PCP's (primary care physician, same as your GP, I expect) group has an x-ray department in the same building as the office, so I only have to go upstairs to get an x-ray. Specialists like orthopedists would have a machine in the office. Other doctors would send you to a hospital or imaging center. Likewise for anything more serious than an x-ray, like an MRI. Hope that helps.

[innocent_lex]

That does help, thanks. Is your PCP an average-size place? Small town? Medium? Huge city? If my character is in a small town with small town doctor, would that make a difference?

[readerjane]

I think a small-town doctor would be more likely to send his patients to a hospital to get x-rays. Our doctor's office has an X-ray machine on premises, but for any more advanced imaging (CT scan, MRI) we still have to go to either a hospital or a facility that specializes in imaging

[innocent_lex]

Thanks. It sounds like US doctors have a bit more equipment than we do, which is a helpful thing to know. I think we have the same kinds of restrictions on talking about medical situations with families, which can be a bit weird at the GP. But in the hospital discussions are generally fairly open with family members.

[geminia905]

Might depend on where you're at. Not sure about big cities, but around here most of the times I've had x-rays they've been done at the hospital (of course, they were usually emergency situations, too). I think one of the local clinics might have their own x-ray department and my orthopedic surgeon had his own, but our family doctor (back when we had one) would send us to the hospital for x-rays or anything like that.

As for medial records, I think it would depend on what the situation is when it comes to how that's handled. They're usually very careful about giving out patient medical records to anyone.

[innocent_lex]

Thanks for that. What's the difference between a clinic and a doctor's office? Is there a sliding scale of medical locations?

[geminia905]

Hmm. How to describe it.

The clinic in question is essentially just a group of doctors who work together in the same place. When you go in as a patient, you either are there to see a specific doctor who's treated you before or they will set you up with the doctor who best suits your needs.

When we had our own family doctor, he had his own practice and we'd go to his office and he'd see us, prescribe treatment, etc. and we'd pay him directly. When we go to the clinic, we pay the clinic rather than the individual doctor.

[innocent_lex]

Thank you, that's clear. It sounds the same as here, though I think we just wouldn't call it a clinic. I sign up with a GP and they may work alone or with a group of others. The rest is the same, except the money. We pay for prescriptions which is a fixed amount per item, I think around 8 or 9 quid these days. I have a pre-pay for mine which means I save money on the year.

[khek]

I've lived in both a small town and the suburb of a city. In small towns, they send you to the hospital, because most practices (even group practices) can't afford the specialized equipment. In some cases, the hospital itself is too small, and patients are sent to larger hospitals to be seen by more experienced doctors and technicians. (And in some cases, you wish they HAD sent you to the bigger hospital, because the East Bumfuck Hospital is more likely to read your tests wrong or figure out they can't fix you in the middle of a treatment. They also tend to lose patients more than bigger places, or have to keep them longer

[innocent_lex]

Yeah, we also have a varying level of quality in our hospitals, and student doctors have to do rotations at both a good hospital and an, er, less good one. For example, the nearest hospital to me with a casualty department isn't one I'd like to spend any time in. I've been to others that are much better.

Thanks for that - very useful.

[nialla42]

I'm in a rural area, and at least three family doctors (close to what a GP is) I've been to in the immediate area had their own x-ray equipment. I (luckily) haven't had to use one in 15+ years, so I'm not sure if they're still operating them. It was only for the basic "Is your arm broken?" scan, and if it was, then they'd send you on to the hospital for it to be set.

My current family doctor moved into a new building a couple of years ago, and I'm not sure if they have x-ray equipment. I think a lot of doctors don't simply because it would mean having specialty training to operate the equipment and read the results. That adds more to expenses, when they're not set up to deal with emergencies 24/7 like a hospital is. Though a lot of people prefer to go to their family doctor for an opinion if possible before going to the much more expensive ER (A&E).

Health records are protected by HIPAA, which is a Federal law. You can waive part of those rights by signing a release form. At this point, I put my mother's name and my BFF's on release

[innocent_lex]

Money! I keep forgetting that part. Yes, I need to take that into account, the idea that everything needs to be paid for as well. That adds a wrinkle. Thank you.

[nialla42]

This might be TMI, but I thought it might give you some perspective on the payment issues

[captain_tiv]

I live in a more rural area. There's a doctor that is literally a franchise in my county. "Everybody" chooses him as their primary care physician and he takes just about every insurance there is. He has offices in the north, mid and southern sections of the county. His main office is set up with everything from a mammogram machine to an x-ray. Some of the other satellite offices don't have mammogram machines. From what I understand, they all have x-rays. The main office has a lab to run all sorts of tests. All offices can run the pee tests.

Here, they try to keep you out of the hospitals. They want you to go to your own doctor for most things.

A big city and a rural area would be different as far as medical care goes. If they're really rural, they might be lucky just to have a clinic with one doctor taking care of an entire town. Where I live, we have a county hospital and multiple doctors offices. In the city, there are hospitals everywhere and doctors have fancier offices.

[innocent_lex]

Ooh, labs. That's another thing - we don't have those at the GP here. They can take blood but they have to send it all off to somewhere else to get it tested. No idea where the somewhere else is. Maybe labs, maybe hospitals?

So, is the clinic what you call the doctor's office? How small-to-big would a clinic be? Do you have a 'medical centre'?

[captain_tiv]

"Doctor's office" is a term that is different depending on where you live. :) Where I am, a doctor's office is one where a doctor can see a lot of patients. There may be as many as 20 exam rooms in some, as few as 5 in others. They usually have simple x-ray machines, an ultrasound, a lab that can do some simple tests like a pee test. A few doctors offices will be better stocked with equipment. In my case, the main office has all sorts of gadgets but the satellite offices can do simple tests but send some of the more sensitive tests to be done at the main office. I think if you needed to get a mole removed and wanted it biopsied, they would send it out. I know they did that with one of mine years ago

[innocent_lex]

Ooh, okay, thanks. I think I need to change a couple of things I've written, particularly around the access to records. If you ask to see your own records, would they produce them right away or would you need to wait a while?