Non-local neurologist: is this going to work?

I’m trying to decide between two private neurologists - to confirm diagnosis, talk about prognosis and recommend any treatment.

At first, I was planning to see someone in London. It was hard to find anyone more local, so I just looked for MS specialists who seemed to be really engaged in treatment and research.

However, when I mentioned to my local MS team that I was thinking of going private, they seemed to think that nobody would be prepared to see me “out of area”. More alarmingly, they did not seem to have any system in place for follow up if a non-local private neurologist recommended a DMT. My impression was that they might just ignore any recommendation or insist I also go through their system - they were very negative about the whole idea. And they eventually suggested I see the one local MS neurologist who does do private.

However, when I looked up this local man, I found very little information about him, little to suggest he is really engaged in terms of keeping up with research developments, trials etc. in the way the people I’ve found in London are.

So now I have a dilemma. I can get an appointment quite soon with this local chap, he would have access to my records, and would know how to plug back in to the local system. If I need ongoing treatment, it would have to be monitored/delivered locally, I presume.

However, part of me would still try to see someone who really does seem to be at the top of the field. And if I have ppms, as I suspect may be the case (no obvious “relapse” pattern), then maybe there will be no ongoing treatment for now…

If you went out of area for a consultation, what happened with any subsequent treatment? Did you continue to have non-local treatment, and if so, did you do this on the NHS? How feasible was that in terms of needing blood tests and so on? Or did your local MS team pick up on recommendations?

“London” doesn’t equal better. Sure, there will be leaders in research in London (Barts, Imperial etc.) but for practical application of current practise, Neurologists and Neuroradiologists will have trained all over the world and pop up all over the world, including in your local NHS trusts.

Private doesn’t have to mean better either. Just quicker.

Save the private sector option until after you’ve had a diagnosis through local NHS channels, if and only if you need a second opinion?

For NHS hospital-based neurological services you’re going to be formally under the care of an NHS consultant neurologist. He or she is the person who will decide which, if any treatments you will be offered on the NHS. So if you’re getting a private opinion, it usually makes sense in the first instance at least for that to be from the same person.