Frequently asked Questions:
2. What do I need for my first consultation?
A: A referral letter from either your general practitioner or physiotherapist is required. This may have already been sent direct to the Mr Bhat’s office. You should also bring your insurance policy number and authorisation code for the consultation. Any X-rays, MRI scans or previous correspondence should also be brought to the consultation. If your x-rays/ Scans were done at a different hospital, you can ring the Radiology department in the hospital you are being seen by Mr Bhat and request for these images to be transferred online.
A: In the private sector, you will always see Mr Bhat. In the NHS, this is not guaranteed.
4. How long will the consultation last?
A: The standard new patient consultation lasts up to 20 minutes. Some conditions are very simple and a through explanation including demonstrations with anatomical models can take only 10 minutes. Some complex conditions can take much longer and Mr Bhat has usually identified these patients and made allowances for extra time. Follow up appointments last up to 10 minutes but again can vary from a few minutes to 20-30 minutes. Either way Mr Bhat hopes that at the end of the consultation enough time has been given to fully explain the issues involved.
5. How much does a consultation cost?
A: Costs are usually covered by your insurance company as they are within the normal guidelines. Please discuss matters further with the office if you have any queries regarding this. Prices are set according to the scales produced by the major insurance companies on all of whose lists Mr Bhat is registered. Mr Bhat is recognised as a Provider by all the leading insurers and will charge reasonable and customary rates which, with very few exceptions, are accepted by the Insurer.
6. Will I need an X-ray?
A. Conditions that affect bone such as fractures and arthritis often need x-rays. An x-ray will be done on the same day and the results discussed with you by Mr Bhat. Most Insurance companies cover x-rays as part of the initial authorisation, but please check first.
7. What if I need a Scan?
A: Scans (MRI, CT, and ultrasound) are expensive and authorisation is almost always required by the insurance companies. Scans are usually performed on a separate day and a follow up appointment required discussing the results. On the day of the scan I recommend patients making a follow up appointment for a week by which time the radiology doctor will have had time to review the images and write a report and discuss this with Mr Bhat.
8. What if I need Surgery?
A: The decision for surgery is not always easy and adequate time will be offered to ensure you understand what is involved. Occasionally I ask patients to see my Hand therapist before surgery to discuss the rehabilitation post operatively if particularly involved. Once you have decided on surgery you will be consented for the operation and an OPCS code given. A suitable date will be decided in clinic or arranged with my secretary.
9. What is Consent?
A: Consent is a very important part of the surgical process. It is the process in which the patient and surgeon have the opportunity to discuss the planned surgery in detail and be fully aware of the risks and benefits. A signed document outlining the procedure, risks and benefits is filed in the notes and a copy is retained for the patient. I encourage patients to provide their e-mail, so that information leaflets specific to your procedure can be sent out by my secretary, when possible. This will empower you ask questions at the time of consenting.
10. What is the OPCS code that my insurer asked me to obtain?
A: The OPCS code will represent a particular operation. It will consist of a capital letter followed by four numbers. For example a carpal tunnel decompression operation will have the OPCS code A6510. Mr Bhat should be able to give you the code once a decision has been made to perform surgery. Occasionally multiple OPCS codes are required for one operation and this would represent two or more different procedures being performed in the one operation. Once you have been given the OPCS code you should inform your insurance company to obtain authorisation.
11. What are Day Case and in-Patient?
A: These terms describe the amount of time spent in the hospital. A day case operation is performed and the patient is allowed home on the same day. An In-patient is kept in overnight following surgery. This may be for a variety of reasons such as co-existing medical conditions, social circumstances, more careful observation required etc.
12. What should I bring with me on the day of the operation?
A: The level of surgery and length of stay may dictate what you should bring. All patients may require to wait a few hours before the operation. It is advisable to bring a book or lap top to help pass this time. Newspapers will be provided. We would recommend a pair of slippers and bathrobe. Patients staying overnight may wish to bring wash bags and toiletries.
13. Local , General or Regional anaesthetic?
A: Local anaesthetic involves injecting a solution around where the operation is to be performed, whilst you are entirely awake. It is usually injected in the operating room. The area takes 5-10 minutes to become numb. Mr Bhat will not start the operation until satisfied the anaesthetic has worked.
Some patients prefer to have conscious sedation administered in addition to the local anaesthetic. The sedation is administered by a consultant anaesthetist.
Regional anaesthetic (Blocks) involves injecting the same solution in the neck or arm pit to anaesthetise the whole arm whilst the patient is still awake. This usually takes 30—40 minutes.
General anaesthetic involves putting the patient to sleep for the duration of the operation. At the end of the operation either local anaesthetic is injected into the wound to provide post operative pain relief or the anaesthetist has performed a block.
14. Who will do my operation?
A: Mr Bhat would perform all private operations. Occasionally for complex cases he is assisted by another experienced surgeon. There will be no extra costs incurred if an additional surgical assistant is required.
15. Who will I see after my operation?
Mr Bhat will usually check that you are comfortable and in a satisfactory condition to leave the hospital. You will be followed up in the outpatients department either by a nurse, a hand therapist or by Mr Bhat, If there is a simple bandage this is reduced after 7 days in clinic. Patients may be seen for mobilisation or splinting by a hand therapist in the first week.
16. What if things go wrong?
A: Complications are fortunately quite rare in hand and wrist surgery. However they still can occur. The close post operative attention that you will receive from the nurses, hand therapist and Mr Bhat would hopefully identify and problems early so that they can be rectified. You are free to call the hospital where your operation was performed and ask to speak with the Resident Medical officer or the duty sister, who may arrange to see you. If necessary, they will contact Mr Bhat to ensure that prompt and correct management is initiated.
24. Why do my Insurers say that you do not follow their guidelines?
A: There are many insurance companies and all have a different tariff for the same procedure. Mr Bhat’s charges for the procedure is fixed according to WPA, which is an insurance company. The reasons for this are firstly, because it is much easier for secretaries with billing and secondly, because WPA has consistently proved to be fair with both patients and the medical profession.
25. Is Mr Bhat a Hand Surgeon or a Foot Surgeon?
A: Over the years, Mr Bhat has developed an additional special interest in forefoot surgery. He has regularly operated on Bunions, Hammer toes, Morton’s neuroma, big toe osteoarthritis and several other foot disorders. He treats foot and ankle injuries routinely in the NHS and private sectors. He constantly updates his knowledge of foot surgery attending national and international meetings on foot surgery.