what kind of doc shall I see about a knee injury and how does the UK med system work?

March 19, 2008 6:17 AM

what kind of doc shall I see about a knee injury and how does the UK med system work?

short version:

this is a two-folded question:
1. my knee is hurting and I'm wondering what kind of doc to see about it.
2. I'm new to the UK and have no idea how the whole insurance/billing stuff works here when I go and see one. all I know is the american system. I don't even know where to look for the right md here.

long version:

I started working out in earnest about three years ago. quite soon into my sessions I discovered that lounges were uncomfortable for me. every time I got up from them, my left knee made a slight popping sound. it was as if it went past a little resistance. it didn't hurt, it just sounded odd. I noticed the same phenomenon happening when I climbed stairs - with every single step I took - or while riding a bike. after a couple weeks of running I decided to see a doc in nyc. they did an MRI. the verdict was that I had just taken it a bit too far, that nothing major was wrong, that something was just a bit inflamed. (my apologies, I forgot the exact terminology.) go easy for a bit, no big deal. only now it is a big deal.

I pretty much stopped running last december because of it but it has only gotten worse since. taking a flight of stairs now hurts on the upper outside of my knee. this has become problematic since I've moved to london - the tube is littered with stairs. riding a bike is pretty much impossible. I don't think the running caused it but it might have made it worse. jumping down a flight of stairs is making me cringe. the impact produces a painful sensation on the upper left part or my left knee. imagine it like the feeling of being very sore only not in a muscle but a joint or bone. this is reproducible - it happens every single time I take a flight of stairs, ride a bike, tale a leap even.

clearly I need to see a professional about this. the question is just what kind or doc do I seek out? also: I've only just moved to the UK and am currently doing freelance work, so I am not covered by a health plan yet, although I am a EU citizen and have a new british NI number. I am not sure if I can see a doc here without being hit with a massive bill like I would be in the US, so any knowledge on that would be much appreciated as well.

anyone wanna point me into a direction here?

posted by krautland to health & fitness (11 comments total)

If you want to be seen quickly, you'll probably want an NHS Walk-In Centre in the short term. Here are a number of them in London.

In the very short term, remember RICE (Rest, Ice, Compression, Elevation).

Were you sent an NHS card when you started working? If so, phone GP surgeries close to you and get registered. Once registered you can make an appointment. Depending on where you live it might be easy or hard to find surgeries taking new patients. If you are registered with the health service in any other country but don't yet have an NHS card, getting the
posted by methylsalicylate at 6:48 AM on March 19, 2008

Welcome to the wonderful world of the NHS.

Your first step: Go to NHS.uk, choose "GPs" and enter in the postcode where you live. Tell them you're new to the area and would like to register and get an appointment with one of the doctors.

They'll book you in, and you'll have to fill out a form with a few details (address, etc.). Hand that in at reception, wait for the doctor to see you, and then tell him/her what's up with your knee.

She/he will look at it, ask you a few questions (repeat pretty much what you said here), and, if it's something she/he can't solve, she/he'll refer you to a specialist. You'll have a bit of a wait, but you will get it checked out.

If you need a prescription, you'll get one to take to your local pharmacy. If you need to book another appointment, you can get one. And then you walk out the door.

Prescriptions at the pharmacy are £6.85 (but rising to £7.10 in April). Depending on what your doctor says, that might be all you spend for the entire thing.

£6.85.

No, really.

That's what the NHS does.

Don't get a health plan, don't go private, just pay your taxes and love the NHS.
posted by Katemonkey at 6:48 AM on March 19, 2008

(sorry)... European Health Insurance Card might be useful.
posted by methylsalicylate at 6:49 AM on March 19, 2008

I'm not a doctor, Londoner or lawyer (or physiotherapist) but I have had knee problems.

You have the choice of using the National Health Service, going entirely private, or a mixture of both. I've had great service from the NHS in sorting knee problems out, although I don't live in London.

This guide to national health service charges should help you work out what your options are. Reading this, it seems clear that you'd qualify to get helped for free:

Bullet point 3 under 'who can receive NHS treatment free of charge' lists anyone who's come to work, including the self-employed, so I imagine that your best bet is to contact your local doctor's surgery, register with them and get them to advise you on what proof you might need to offer to confirm your status as a freelancer working in the UK.

Your GP (doctor) can then do an initial assessment and refer you to the right specialist - from there you have the option to use the NHS for free, maybe go private within the NHS (pay for faster service or treatment that's not free) or look to the private sector to provide physiotherapy, an operation, or both.

But honestly, for all it gets knocked in the press, the NHS is generally pretty good. I'd use them for all that you're able, and maybe just seek private physio if this prevents you from having to wait, or is just more convenient.
posted by dowcrag at 6:50 AM on March 19, 2008

Depending on how the UK system works (I don't know the answer to that part of the question--but on preview, the other folks have addressed this), you might have to see a primary doc first, anyway, but it sounds like an orthopedist, particulary in sports medicine, would be appropriate.

Pain on the outside of the knee like that, if it doesn't feel like a muscular pain, especially going DOWN stairs, could be iliotibial band syndrome (ITBS). The IT band is the tendon that runs from the outside of your knee to your hip. ITBS is generally an overuse injury, often from running. It sucks as an injury.

IANAD, but a former runner with a wealth of injury experience. I struggled with ITBS for a while a few years ago. I got rid of it with PT, orthotics, and this thing called the foam roller.

Also, no matter what your injury is, one thing if you start running again is to make sure you are wearing the right running shoes for you. The wrong shoes can cause all sorts of injuries and unpleasantness.
posted by Pax at 7:01 AM on March 19, 2008

According to this

You can receive free NHS hospital treatment if you:-
...
-have come to the UK to work, either as an employee or self-employed person. This does not include people on short business trips
...

So NHS treatment is free for you. As to who to contact, in the NHS you usually register with a General Practitioner of your choice nearby, they would in turn refer you to a specialist. You can use the website of your local NHS trust to find nearby GPs, or use this website to find nearby health services.

If you want to see someone now, and not have to wait until you find a GP that you like and who is accepting new patients, then I don't know, maybe go to a walk in clinic which you can also find on that site. Or call NHS Direct at 0845 4647 and ask them.

On preview, yeah, what they said.
posted by atrazine at 7:03 AM on March 19, 2008

When you register, you may need to bring proof of address along with you to prove you're in the cachement area. This can include things like bank documents, utility bills, etc. Everyone else has nailed it: register and go see your GP.
posted by lumiere at 7:05 AM on March 19, 2008

You may also want to bring your passport along to register - increasingly surgeries are checking to ensure you're entitled to NHS care before putting you on the rolls.
posted by wayward vagabond at 7:26 AM on March 19, 2008

nthing: Register with a local GP. Get an appointment. Call NHS Direct in the meantime, or find a local walk limp-in centre. Do not fear the NHS.
posted by holgate at 10:21 AM on March 19, 2008

update: I went to an nhs walk-in centre and they told me to take painkillers. seriously, the nurse didn't even want me to see an md. quite confusing, especially since the reaction I got in the US to my situation was far more serious. I'm a bit lost as to where to find a GP but will try to find someone besides this nurse to check out my knee.
posted by krautland at 4:09 AM on March 27, 2008

Different health care systems can be confusing, I know, and it does take some time to learn to navigate them! I hope you check back in this thread. Not all walk-in clinics have doctors as they've been designed to decrease the load on hospital A & E departments by treating people with minor ailments who really really really don't need to be taking up emergency space. This may be why, as someone with non-critical joint pain, you were told to take painkillers and then sent away.

To find a GP, follow the instructions in the thread: go to this page, enter your postcode, and a list of practices near your house will pop up. Ring or click through to ask if they're taking patients and, if they are, ask how to register and when you can make an appointment. Clinic opening hours and services provided are also listed when you click through; if you work long or strange hours, it can be worth trying to find a GP who runs commuter surgeries in the early morning or later in the evening for this purpose. And there are even performance and survey results for each surgery when you click through from NHS direct (links at bottom of left sidebar) - I wish I'd seen this before registering!

If your brand spanking new GP refers you on to a specialist (as it sounds like you should be), know that you know have increased choice of specialist, clinic, and hospital. There's loads more info here. It is a good idea to register with a GP as soon as you can; it'll always be easier to get an appointment when you really need one if you've already registered.
posted by lumiere at 12:29 PM on March 29, 2008 [1 favorite has favorites]