To be a put out by this GP referral

Totally😂
"OT please review" Review what???!!!

I get things like "want better communication"
"doesn't talk" (they're a non-verbal communicator)
or "needs SALT" (like dude, help me out and narrow it down a bit - are they dysphagia, communication or requiring an accompaniment to their fish and chips?)

The one which winds me up and I'm on a personal one-woman crusade about is comments complaining an autistic individual hasn't made eye contact. That one drives me flipping nuts!

Mind you - I'm an obese autistic which is just diagnostic overshadowing central in terms of what they can fob off onto those preexisting diagnoses! Went to register with my current GP and had to fill in the forms which declared my ASD and the receptionist got all arsey and eye rolling with me - then asked me for ID and the only one I had handy (I'd rushed in on the way between work appointments) was my NHS ID - was quite satisfying watching her realise she'd been making a shittone of incorrect assumptions there (I intentionally sometimes dress very casually visiting clients as a lot of my guys really do not respond to uniforms or feeling like they're dealing with someone who doesn't relate to them)

PTSD is relevant because we are practicing under principles of trauma-informed care which means we have to be alert to how procedures might cause trauma and work towards preventing it. The fact that you, as a nurse, found it to be a loaded comment is worrying to me.
The rest of the letter is factual and nobody needs to know your full history for an MRI scan, just a reason for referral. When you have an appointment with a consultant, you can talk tot hem more about your health history.
Most referrals I see lack any detail whatsoever and just have a copy of the latest GP consultation. I then have 90 minutes with the patient to "excavate" the rest of the detail. I would consider myself lucky to receive this referral.

I've ticked YANBU because I get annoyed reading copies of GP letters as well, the way they select some information to include and leave out other (what I think) important facts.
But realistically, after reading the replies here, I realise they have to be succinct and put what they deem is relevant.

It reads to me that your request for meds is evidence of increased pain, which would be reason to sanction the MRI.

My last one did!!

Is that code for didn't kick off?

I have never read a letter from a consultant or GP about me that hasn’t muddled up something I have said.

Because on the card was one line- at best. Possibly totally illegible. That was acceptable at one point- now its not.

Yes- medics practice defensively. Because its an era of litigation- gotta cover your back because its possible that someone will decide to complain 10 years later- then all you've got is your contemporaneous notes.

Re the diazepam. Stating that you ( the patient) has requested an increase is trying to make the point that symptoms have worsened, the condition is not properly controlled and therefore the scan is justified - its not trying to paint you as a drug-seeker.

Did it say you were 'pleasant'?

Must admit I've also been a bit miffed sometimes now that I can see GP/nurse notes on the NHS App. Things I thought important enough to mention not written down and other irrelevances made a note of. I also think that the notes are written in such a way to "protect" the GP in case of misdiagnosis etc - can't really put my finger on it, but it's just the manner in which the notes are made with seemingly trying to evidence picking out certain things I've said or certain aspects of my medical history to make it fit their treatment/diagnosis but ignoring other things that would point to a different diagnosis, as if I didn't say them.

Eg, a recent case, during a diabetes review appointment, I mentioned in passing that I used to binge eat up to a couple of decades ago. Upon checking the NHS app, they'd put a note on to say I was a "binge eater" (current tense), with no mention of it being in the past. At the next consultation, I made a big thing of telling them my binging was 20 years ago and asked her to make a note that I wasn't currently binging and it was in the past, so as to correct the medical history! To her credit, she did, but it shouldn't have been wrongly noted in the first place.

I do wonder what has been wrongly noted in the past 40 years or so of seeing GPs as an adult. Back before computers, the GPs used to make hand written notes on the card in an envelope, which was basically just jotting down a one line summary of the consultation. Despite being old fashioned and antiquated, the GPs seemed to be able to check your history a lot quicker just by scim-reading a card, as opposed to how it seemingly takes them half the appointment these days to flick through screens and delve into computerised notes etc.

I get it, I'll forever have health anxiety on my notes, because in a period of 4 months 9 years ago I had two separate illnesses, a burst appendix and then sepsis after never being ill in my life significantly.

So I was absolutely anxious for a few months after, and apparently I'm never allowed to forget it!

It's more detailed than some of the referrals I get at work which are "bang head on desk" levels of frustrating, or "copy and paste the entire medical history from the care portal" levels of irrelevance.

☺️ I get it OP. I’ve been on there with inaccuracies that became Chinese whispers and delayed diagnoses. It’s not imaginary.

If you’re unlucky enough to have frequent gp changes or locums etc then when they scan back quickly through notes these errors or implications can give a particular impression. They often don’t have time or the will to take their own history or form their own opinion. Time is wasted correcting or explaining and it doesn’t help a doctor/patient relationship to look like you are arguing. It can be really unhelpful or harmful.

You are not being over dramatic and @lessertenantry is right. It would be my impression that the GP is trying to present a particular image of you to other healthcare professionals, which will impact on how they interact with you and treat you.

I understand your feelings. I've seen things written on doctors' letters about me bringing up completely irrelevant things about me that have made me feel really icky.

This was my thought too.

Selective presentation of facts can create a particular view though can’t it. That can be intentional or unintentional. It may be a ‘read between the lines’ hint to the person who reads the letter, prompting them to interpret results in a certain way. There definitely used to be doctor ‘code’, less so since patients often get copies.

"requesting Diazepam increased today as well as a new script for Co Codamol and Naproxen"

Stating that the patient is requesting a new script may be a mistake or may be suggesting that the patient is drug seeking. If the referral letter suggests the person is looking for an excuse to be prescribed serious opiates then, since all MRI can contain anomalies that are not always clinically significant or it’s unclear as to the extent, this could affect the interpretation and the delivery of the results.

If GPs are going to include an history as extra information then it needs to be exact.

They should also be direct enough to address concerns like drug seeking or hypochondria directly with the patient.

I think you are being a little over dramatic here, it is only an MRI not a Consultant referral I presume. I am also an ANP Nurse Prescriber and I fear sometimes we have too much knowledge (although not necessary a negative) we like things to be correct.

It’s just a referral for the MRI, no? Any slight inaccuracies won’t be an issue in this instance, or affect the outcome.

This reads as a fully comprehensive referral letter showing that a thorough history was taken into consideration and written by a clinician that is paying attention. A referring clinician needs to give a full history that is clearly relevant to the diagnostic requested which includes prescriptions relevant to your pain issues. Any consultant I've worked with will also read through a patient history to be sure nothing is missed especially if a referral is a bit "sparse". I would be pleased with the attention to detail in this letter. Whilst the PTSD was successfully treated it is still something to be made aware of.