HOW I WORK

Patients will require a referral from a general practitioner, paediatrician or medical professional before I see them. This is for various reasons :

• Health insurance companies requirement for authorisation of treatment.
• I often need professional information about a patient's health and development.
• I may need to ask the other doctor to carry out further treatments, and they are not likely to do so if they did not request the referral.
• In the U.K. healthcare system, the G.P. holds the overall view of a patient's health, and is the gatekeeper to specialist care. It is professionally proper to recognise this.
• A referral letter will provide me the information to ensure the correct specialist is selected.

For  children: A school/ nursery report may well be particularly illuminating, but I will not contact your child's school without your permission. 
For adults: A questionnaire and obsevrations from patrners/parents are helpful. 

I write a report after my assessment with a short letter to your referring doctor, after having received your consent. If there is a need for a psychological treatment, I will frequently refer on to a clinical psychologist, or psychotherapist. If ADHD medicines are to be involved, then I will usually manage these myself, often jointly with your G.P, or paediatrician.

First appointment 

Should I be asked for a first appointment, this will usually last one hour and a half. 

If I need to see you or your child again, it will be for a shorter period.

I may need to carry out a physical examination on a child but can manage this without taking all their clothes off. I do not often need to take blood for tests. ECGs can be asked to be conducted with the GP or other specialists, as well as rarely EEGs or other complementary exams, when medically relevant. I rarely need to request a brain scan, which will need a separate arrangement. 

In most situations, assessment is a first step into a more global care plan which involves implementing the right treatment setting. 

Altogether, I understand assessment as a process during which we will already be working on a practical care perspective. Assessment is not only providing a diagnosis and a care plan. It is also starting implementing changes in daily life. 

Conducting first appointment and/or assessment with a child/Young adult

It might be helpful to explain to your child what sort of person you are taking them to see. I suggest that you say the following: That you are taking them to meet a doctor to see if there is a medical reason for their problems, they will return home afterwards, the doctor will ask them some questions but that it is not a test or an exam. 

Main attention is given to patient’ speech. I always start with introducing to the child/young person/adult and taking it from where he/she is. I then come to parents with their child around because I think it is important for him/her to hear what we are saying. 

In order to assess the situation, I have to ask many questions to both parents and the child or young person. I ask these questions in a conversational way. Some questions can only be answered by the parent, others by the child or teenager. It is important that I meet both parents. I usually start by seeing the child with his parents because this allows me to gain an understanding of all the concerns, as well as to obtain everybody’s perspective and assess the young person’s disposition in the presence of their parents. It also enables me to observe the child or young person without embarrassing them. There is usually more than one problem and more than one view to each problem. It is also a way of engaging the child into the all-care process. I often like to see all children over the age of five years on their own in a way I usually manage to make pleasant and helpful for him/her. This can usually be done within a single appointment.

As already mentioned, it is sometimes very useful to have a report from school. Learning, social interactions and Education itself are an essential part of one child’s life. Should we decide to communicate with school, this would also be used as an opportunity of engaging the Education setting in the global process of one child’s achievement. 

Should you consider it would be meaningful meeting you without your child around, please let Lydia, my admin person, or myself know about this. You should be offered another appointment.

Post assessment (60-90 minutes) 

Following the assessment should you ask me for a treatment to be implemented, I would offer post assessment appointment. 

It is dedicated to providing you with an extensive feedback about the assessment. We shall take time to list what it involves and to understand it in a practical perspective. This means taking into consideration any treatment aspect. My priority is to make sure any information related to diagnosis and treatment is very clear for each of you. I feel crucial for the care plan to be tailored to my patient’s needs and resources, and to be realistic as well. 

If for instance ADHD medicines need to be involved then I will manage these myself, jointly with the referring GP or paediatrician. On the subject of ADHD medication:  My opinion is that making a decision on them needs rigorous method and specific pathway to be processed. This time is also used to let my patients learn about what medication is as well as about ADHD and its global impact on daily life. This is all to say how essential is to me the self-knowledge a patient will be developing throughout the assessment and possible treatment process. This is an investment on future achievements and happiness. 

Follow up appointment (30-45-60 minutes)

Follow up appointment can be offered. Their frequency will be decided by me according to my patient's needs. 

Indeed, I can do very little in any case without your support and cooperation. 

I am looking forward to meeting with you.