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Second opinion query


JohnRoss

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I am sure this has been covered before but cannot find the relevant post so:

Following several years of misdiagnosis I have had a diagnosis of sacroiliitus, very painful,  from a  rheumatologist that my GP sent me to see. Because the treatment proposed has associated risks and is complicated by my other medical conditions I would like to be sure that this latest diagnosis is correct. A friend has recommended another  rheumatologist that I would like to see for a second opinion. My question is can I just make an appointment and be reimbursed by both the CPAM and top-up insurance company or must I see my GP again for referral first?...............JR
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You are perfectly entitled to see any specialist you wish, but if you choose one that you have not been referred to by your medicin traitant, a lower rate (usually 30% rather than 70%) of reimbursement from the state system will apply. Depending on the terms of your top-up policy, I think you should get the normal percentage, but it may or may not be made up to the full amount, depending on the terms of the policy and the percentage of cover.

See the table on this page.

Note that there are some specialists, such as optometrists and gynaecologists, whom you can consult without being referred by your medicin traitant.

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Thanks for the info folks. Going to have to be a bit diplomatic on this one as the G.P.s initial diagnosis of sciatica was influenced by a radiology doctors report which according to the rheumatologist was in error or rather not based on enough information following further scans and X-rays. Have emailed the top-up insurance people to see what their attitude would be to a self referral, no reply as yet. Have already discussed the proposed treatment options with the G.P. who clearly has reservations about the drug Humira versus Cortisone. All a bit complicated and already have appointments to see cardiac consultant and a gastroenterologist so I am going to be poked and proded rather a lot in the next few weeks................JR  
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Hi my wife has Rheumatoid Arthritis and has suffered from it for over 35 years. She has been through all of the treatments over the years and has now been on Humira (have suffered a reaction to another product) for many years and self-injects twice a month.

Equally she has to take steroids.

Humira is one only in the stable of drugs which addresses such illnesses and indeed today there are newer drugs on the market place. We have an appointment later this week with our specialists in Niort and it is likely that Humira will be stopped and once a month my wife will have to go into hospital for an infusion. A starting point would or should be the Arthritis Society web site.

There are very good Rheumatologists in Nantes and Montpellier and Bordeaux.
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