Working with complex chronic illness takes time, and I think it's important that you know what to expect before we begin.
My aim is to provide thoughtful, individualised medical care, with clear communication, realistic expectations and a treatment plan that we develop together.
Your first appointment
Your initial consultation lasts up to two hours. This gives us time to explore your medical history, current symptoms, previous investigations and treatments, as well as any environmental factors that may be relevant.
Before your appointment, you'll be asked to complete a detailed health questionnaire and provide any relevant previous investigations or medical records. This helps me understand your history and make the best use of our time together.
I generally spend the first part of the appointment gathering information and understanding the wider picture. We then move towards discussing what may be contributing to your symptoms, identifying priorities and agreeing a practical starting point.
It's important that we leave time to make a plan, rather than spending the entire appointment gathering information.
I see adult patients aged 18 and over. Initial appointments are preferably face-to-face at UNTIL in Marylebone, London, although video consultations are available where appropriate. Follow-up appointments can take place in person or online.
Following your consultation, you'll receive a written summary of our discussion and agreed treatment plan.
Follow-up appointments
Follow-up appointments allow us to review progress, discuss investigation results, assess how you're responding to treatment and agree the next steps.
Appointments are available for 30 or 60 minutes. I generally recommend a 60-minute appointment for the first detailed review of test results, as there is often quite a lot to work through.
Shorter, 15-minute troubleshooting appointments may be available by prior agreement for focused questions about an existing treatment plan.
Treatment plans aren't fixed. We review and adapt them according to your progress, response to treatment and what is manageable for you.
Testing and investigations
Many of the patients I see have already undergone extensive investigations, sometimes over several years. An important part of my work is reviewing what's already been done, identifying what we can learn from those results and considering whether anything genuinely useful is missing.
More testing isn't always better. I recommend further investigations when I think they're likely to provide useful information or influence clinical decisions. Sometimes we may decide that additional testing isn't necessary, or that it's more appropriate to begin with a carefully considered treatment plan.
Where I do recommend testing, I'll explain what we're looking for, the limitations of the tests and the costs involved, so that we can make an informed decision together. Where investigations are agreed, the necessary test kits will be sent directly to you, together with instructions for collecting samples and arranging their return.
Private laboratory testing is charged separately.
Working together
Good medical care is a collaborative process.
You can expect me to listen carefully, explain the reasoning behind my recommendations and be open about uncertainty. Complex chronic illnesses don't always follow a predictable course, and I cannot guarantee a particular outcome.
In return, I ask that you engage with the agreed plan, let me know when something isn't working or feels unmanageable, and keep me informed about treatments or advice you're receiving elsewhere.
I would much rather know that a plan isn't working for you than have you struggle to follow it. We can then review what's happening and decide how best to proceed.
Communication between appointments
Clinical communication takes place through the secure Carebit patient portal.
I can sometimes answer a brief question or clarify an agreed treatment plan between appointments. Please allow up to seven days for a clinical response.
New symptoms, significant changes or questions requiring detailed clinical consideration will generally need an appointment. This allows me to review the situation properly and make safe, informed decisions.
My administration team aims to respond to enquiries within two working days, and consultation summaries are normally completed within seven days.
