Hi guys,
Here, I see that some people gets very nice care from their doctors about their bike related problems. And I wonder about general consensus about that.
I was living in Turkey until this year. It was easy to see a specialist doctor but those guys always suggest quitting bike. For example my nails was hurting and guy said that just stop biking.
In my current country, Netherlands, I am not even able to pass the GP barrier to see a specialist and those guys just give me paracetamol and sends me back for everything.
What is your experiences about getting the health care?
The few times Iāve needed to (touchwood) Iāve bypassed the GP and went straight to a Physio. In part its the stories Iāve heard about it being hard to get a referral but also the long wait for a NHS (UK) physio once referred.
I think the answer to this is going to depend largely on where you live, both country and region. I used to live in the UK, and specialist care, specifically sports medicine, and specifically preventative care was almost impossible to get on the NHS. I currently live in Boulder, CO, and have amazing access to world class care predominantly through the Boulder Center for Sports Medicine (does not hurt that their facility is right next door to where I work). This does require the right insurance coverage. Lots of preventative care and focus on the long term outcomes (to continue riding for many years to come).
Iāve struggled with injury for over a year now. Iāve found the NHS pretty hopeless, I did however manage to get an MRI by explaining to the GP that Iād been paying for physio but was out of options in that regard. The wait was a good few months, and then another 4 months before I got an appt with a doctor, which was a 10 min convo of āwell youāre walking so we aint gonna operateā.
Just budget in for some proper physiotherapy and bikefitting, and do the rehab exercises. also try accupuncture. Throw enough Sh*t(money) at a wall, and something will stick(fix the injury).
I think that when people have free healthcare, they canāt wrap their mind around paying a few hundred out of pocket if necessary.
@medetkerem Even in the US, primary care docs donāt know much about sports injuries. I consulted two sports medicine docs and even they didnāt know cycling specific injuries. At least they were interested in my case. One did an ultrasound on the spot and determined that my issue wasnāt serious and would resolve itself with time.
Iām surprised that itās hard to find a sports medicine doc in the Netherlands of all places. They have more bicycles than anywhere.
For sports and sports-relatedā¦and maybe just in generalā¦you probably get better referrals from fellow athletes, not from your doctor. The Doc often has contractual obligations for the referralā¦so you are going to get a specialist that is just coincidentally associated with the Docās network. Or maybe youāre getting a referral because the referring doctor went to school with the referred doctor. Not a referral to the best specialist out there.
Fellow athletes are more likely to give you a referral based on the quality of care they received. So definitely ask around among cyclists who may have had similar injuries.
In all of the PPO plans weāve had, a referral was simply instructions from your doctor that you should go see a specialist. Any specialist. Those instructions are available to the insurance company, so when the specialist checks on insurance it signals āits ok, insurance will cover part of the expense.ā Then you pick a specialist and they are either in network or out of network, and that determines how much you are going to pay.
My insurance doesnāt require a referral to a specialist (eta: in network). My primary care physician (pcp) does send referrals to specialists when he makes a referral, and then the specialistās office just calls to schedule the appt.
I called my pcp yesterday morning, because I went over the bars 3 weeks ago when I had a pedal strike on a root and have a hematoma on my thigh that hasnāt gotten any smaller yet, and they told me to come in at 4:30 yesterday. He looked at it, told me to give it a couple more weeks, would send me for x-ray if I wanted (to see if it is brokenā¦said no, it doesnāt even hurt anymore, just have a hand sized bubble on the side of my thigh). He offered to send me for xrays on my hand (some combination of sprains, strains, fractures on 2 fingers, thumb, and wrist) but agreed that everything is functioning ok and any fractures are half healed at this point, so let him know. Didnāt even charge me for the visit (I didnāt pay a copay, not sure if heāll send it to insurance), but reminded me that I was lucky. I said āagain.ā
We have a private orthopedics center, and it has a walk-in clinic, so you might sit there for a few hours, but as far as I know youāll be seen that day. They have have all the imaging equipment there. I suppose theyād send you to the emergency room at the hospital if your condition exceeded their level of services. Iāve been there a few times , so I start by calling my ortho doctor/surgeonās office number and see if they can schedule me as soon as I need, or if I should just go to the walk-in if I need to be soon asap. Met the surgeon when he was at the hospital to do a surgery and was there with a broken tib/fib, gave me some hardware 5 days later after the swelling went down enough. Heās also helped me with torn ac (shoulder) and shoulder impingement on the other side.
USA. I can see whoever I want to see, as long as they have appointments available. But, itās 100% out of pocket cost until I meet my deductible, which is $3000 on my self + spouse plan.
It was great. I have lived in Germany, the US, Canada and Japan. But I have only had sports-related injuries in Germany and Japan. In Germany, I was super lucky, because my mom was the deputy head in the X-ray department of an orthopedic hospital which treated many pro athletes. And in Japan the university hospital took great care of me (I was teaching at the same university).
I think the key is to establish right away that you are an athlete and find a doctor with experience treating athletes. TR really helps, I just pull out the app and show them my schedule. This is also important context for things like overuse injuries or injuries that are specific to a discipline. For example, my mom didnāt know anything about (serious) cycling, except for the injury patterns. If you go over the bars, a common one is side-of-the-head, shoulder and opposite arm. That means you wonāt be able to use both arms for a while.
Navigating the medical system in a given country and region is highly individual. But in most places, you need to be willing to advocate for yourself (or on behalf of your loved ones). Many places require you to have a referral from your GP, so having a good GP is the first step. Like others have emphasized, having a doctor who is an athlete is super helpful. (The doc who did my last knee surgery was a serious runner.)
Iād definitely get your hand X-rayed and quick. Hands and feet are super complex, and even injuries that donāt hurt a lot could lead to mobility issues later on. When I āscratchedā my hand (I could see bones, muscles and tendons), my mom told me to tell the doctor to clean the wound very carefully to make sure I would get any infections.
UK here. The NHS is extremely good with acute, serious conditions and injuries. They are very poor with chronic musculoskeletal problems that do not meet their criteria of serious, especially if said injuries do not affect ADL.
When I had issues with HHT, I googled and found a physio who specialised in treating this injury, rang up his practice, made an appointment, and went to see him. It was a 2 hour drive, but so be it. The initial wait was 3-4 days, the initial visit was Ā£70, iirc, and the follow-up was Ā£50. Following his advice, the injury resolved.
Many surgeons and specialists will also see you without a referral (though you will pay).
If you want the best care for these kind of sports injuries in the UK, you need to do some research and be prepared to pay and travel. The good news is that most consultations arenāt that expensive, and if you do need surgery, the referral from the private consult will often help you skip the worst of the queue.
The one piece of medical advice Iād share, regardless of country, is that you will get better care if you can pique the doctorās interest. Explain why your case is special and what makes it challenging. A good medical professional will do more research, stay current on your case as you progress, and ensure youāre getting the right treatments
Doctors are people just like the rest of us and the more engaged they are with you and your case the better. If you get the feeling they are giving you standard recovery and treatment options without accounting for your athletic history and aspirations itās rationale to seek a second opinion
Every country has its own rules. You canāt connect directly with a medical specialist in Canada without a referral from the GP. Free healthcare but it also stops paid healthcare. You may be able to pay for a broad based supplemental health program but you will still have a very hard time to get access to a specialist
Also USA. Pretty much the same. I can get whatever I want if I can afford it (and usually I canāt). Having teammate doctors has been very helpful with getting appointments for the things Iāve been forced to find the $ to take care of (broken bones).
Iāve had mixed reactions to cycling from health care peoples. Teammates: obviously pro cycling, even discussed whether they could sign off on various cycling costs (such as a new bike) as HSA expensesā¦ jury still out on that. My PCP: very pro cycling in that she doesnāt have to lecture me to stay active. My surgeon: pro cycling, or at least knows better than to try to talk me out of it and was supportive of getting me back on the bike asap. Various nurses along the way: āYou do WHAT?ā and āThe worst injuries I ever see are cycling injuriesāI donāt know why anyone would do that.ā
A referral from a GP is required for most specialists where I live and usually involves a fairly significant wait time (though if you can get one thatās addressed generally rather than to a specific office you can call around and slot in for a cancellation if youāre lucky.)
Iāve found having a good, consistent GP makes a world of difference- a lot of them could give less of a sh*t and are just trying to get people in and out the door as quickly as possible, in which case youāll get the standard āstay off it for 2 weeks and come backā regardless of the issue. The good ones will take the time to understand the injury as well as your history, which generally equates to less time spent messing around and a more accurate diagnosis to begin with, as well as being a lot more proactive in seeking out appropriate specialists and pushing for shorter wait times where possible.
Our healthcare system is thankfully not as expensive as the US or I would have died a few times over, but overloaded enough that itās easy to spend 9+ months circling the public health drain for anything short of kidney failure or a meth overdose.
, so I start by calling my ortho doctor/surgeonās office number and see if they can schedule me as soon as I need, or if I should just go to the walk-in if I need to be soon asap. Met the surgeon when he was at the hospital to do a surgery and was there with a broken tib/fib, gave me some hardware 5 days later after the swelling went down enough. Heās also helped me with torn ac (shoulder) and shoulder impingement on the other side.
