As American doctors, we have a message for British people about the NHS

Jen Gunter

Dr Jen Gunter, a gynecologist from the USA, wrote a post on her blog last month about how much she treasures the National Health Service.

It went viral and since then, she's been joined by other US physicians, who marvel at the British service, and how we can sometimes take it for granted.

Let's have a brief run-down:

1. Dr Jen Gunter

Dr Gunter has previously written about her experiences with the NHS, but she returned to the topic in the blog post, written in August. In the latest story, Gunter recounted her trip to the A&E department at Sunderland Royal Hospital. Gunter was accompanying her cousin who had injured her ankle. The tale contained many things familiar to any person who has interacted with the NHS.

First, Gunter's cousin made clear that on a Friday she would not be able to get a GP appointment until Monday, and that her GP did not have an X-Ray machine anyway, so a visit to the GP would only come with a referral to A&E. Gunter also recounted the labyrinthine route from the car park at Sunderland Royal to the A&E department, and the game of ping pong she and her cousin played between each department, sometimes through pouring rain. These sorts of gripes are common complaints about our NHS. Yet Gunter's blog post delivered its raison d'etre.

To receive this care all my cousin had to do was provide her name and birth date. No copayments, no preauthorizations, no concerns about the radiologist or orthopedic surgeon being out of network. The nursing triage was wonderful and actually doing nursing (I hate seeing nurses relegated to charting). The nurse practitioner clearly knew what she was talking about and had reviewed the films with the radiologist. The surgeon only did the part of my cousin’s care that needed a specialist. It was a great use of resources.

Gunter also emphasised the professionalism of staff, and the fact that:

While the hospital was a veritable maze and in need of the updating that they appeared to be doing, the equipment was all fine and the people, i.e. the things that really matter, were great. Everyone from the porter to the orthopedic consultant was hard-working, knowledgeable, and friendly.

She reported that for the other people in the A&E waiting room their most pressing concern was the use of A&E by patients whose injuries were nowhere near urgent. Gunter then pointed out the the fees and 'copayments' that exist in the US to deter people from showing up at A&E (ER) do little to actually prevent perfectly healthy patients. Moreover, Gunter criticised what she called the 'circle of hell' that is the system of paying for basic procedures such as CT scans. Gunter closed her post by writing:

Dear U.K., the NHS is awesome. Try to treat it a little better...The next time anyone mentions privatization or user fees tell them in America there are people trying to save enough money for the copayment for the CT scan that will tell them if their cancer has returned or not.

Thank you NHS for taking fantastic care of my cousin, of my son two years ago, and of everyone else.

To the British government, stop trying to mess it up.

2. Dr Gavin Preston

3. Marcia Elstob, Southeast Colorado Hospital

In 2015, Marcia Elstob, the Presumptive Eligibility Technician at Southeast Colorado Hospital wrote on YourThurrock about the excellent care she received on Christmas Day from Thurrock Community Hospital. Elstob was suffering severe pain in her mouth and was worried she would not be able to see anyone on Christmas Day, particularly after the horror stories she had heard in America about the NHS.

On Christmas Day the voice on the other end [of the phone] was very kind during her triage of my symptoms. She assured me that Thurrock Hospital would get my information and a doctor would call me...I walked into the most welcoming and clean lobby area, the receptionist was very pleasant; never giving the slightest hint that she was having to work on Christmas Day.

With no tedious paperwork, providing identification, insurance cards, or copies, we were told to please have a seat.

After a short wait the provider called me in to the exam room. Again, from the horror stories I don’t know what I was expecting but it wasn’t the very intelligent, kind, and patient physician who treated me.

A big shout out goes to the 111 system, the staff at the Thurrock Hospital and especially to Dr. Ragavan for seeing me….you saved Christmas!

4. These fifty American specialists

Ahead of the 2015 general election (before British politics surprised many of us with it's twisty turns), fifty American doctors signed a letter, published in The Guardian, that championed the NHS.

In addition to this, they cautioned the UK from following the American example, and adopting insurance based health care system.

The signatories included family doctors, nurses, paedatricians, physicians, psychologists, professors of medicine, among a variety of healthcare experts.

Access to treatment should not depend on whether someone can spare the money. While some may say the changes in England have so far only been at the margins, it is the risk of a slippery slope that should cause concern...The US is in the midst of a major healthcare reform effort that aims to bring affordability and equity to American healthcare. We caution the UK against moving in the direction of a system that has created the inequality in US that we are now working to repair. Your universal, public healthcare system is an example to the world, and something of which Britain should be proud. We urge you to preserve it.


The warning from Gunter and others have received greater attention following the announcement that an NHS scheme consisting of Uber-style system of paid for GP appointments will be rolled out nationally in 2018.

The company 'Doctaly' allows patients to pay between £39.99-49.99 for a same day appointment during office hours, and over £50 for an out of hours appointment (before 9am or after 6pm on weekdays).

Similar to Uber, Doctaly does not employ the GPs involved, but pairs willing doctors to patients seeking an appointment - for a fee.

The family doctors are working privately, outside of their normal NHS working hours.

The Doctaly appointments last 15 minutes, and while patients may not see their own GP or visit their practice, like Uber, they will be offered the nearest available person.

The system has already been piloted in 10 London practices, and plans have been made to introduce this at a national level in the next few years. Doctaly's founder has defended the service, saying it will alleviate stress on A&E departments by allowing people with non-urgent needs to see a GP

While many Americans remain sceptical about the lack of choice and state involvement in nationalised healthcare, these US practicioners have highlighted exactly whats lacking in a for-profit system, and how the NHS continues to impress outsiders. Speaking of the introduction of Doctaly, Dr Richard Vautrey, deputy chairman of the BMA's GP committee, told The Mirror:

Patients want and deserve a properly-funded NHS GP service, based on the registered list, so they can get appropriate timely access to their local GP and that practices have the resources and capacity to offer this...While patients can access and pay for private GPs or consultants, the risk is a more fragmented service and patients having remote consultations with doctors they don't know and who won't have full access to their NHS medical record.

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