to wonder why consultants comment on people's personalities?

It might be useful to track personality and presentation over time. So someone going from "charming and engaging" to "challenging, suspicious and malodorous" would indicate a problem.

Agree with this. You can't write someone is a shit head, but if you put what they said in quotes its fine.

*otherwise not other

@DollydaydreamTheThird and @WhenDoWeFly that's good to know, so it's not some kind of secret code then? So many people I know think it is!

I'd also add that when appearance is mentioned, some people like myself are very good at masking when in a bad way mentally and physically. I worry so much about being judged and what people think of me, that I always force myself to look the opposite of unkempt and to smile and be "pleasant" even when I'm feeling like I can't cope inside. I've had it conditioned into me as my dm always said "they'll think you're a malingerer others and won't take you seriously!"

Reminded by the NfN post, Normal for Norfolk, my medical cousin assures me that in Bedfordshire it's NfB, Normal for Biggleswade, and here in Devon it's NfT, Normal for Tiverton. I couldn't possibly comment!

I worked with a consultant when I was training who told us that ‘man or woman is a descriptor, lady or gentlemen is a diagnosis’…

It just means the letter writer isn't using the pleasant/delightful letter intro.

It really doesn't mean more than that.

Pleasant/delightful are slowly being phased out and younger clinicians are less likely to use them.

Oh that's good to hear.

I hope so!

Is this going out of favour or have I got increasingly less pleasant with age I wonder?

I have been to a few appts in recent years and finding with particularly younger doctors they now just say 'lady' or 'you' as in 'You felt pain etc.." maybe this is a more modern way of writing. Hopefully!

As a hospital consultant of many years, I do not write things like pleasant lady or gentleman. It is very old school and I am surprised that doctors still do this. I might comment that somebody has a good understanding of their illness or treatment plan, but that is that.

I see no need to make a subjective assessment of their personality. In the recent past, doctors used to write quite rude stuff in patients’ notes; that is unacceptable. And I find stuff like ‘pleasant gentlemen’, ‘charming lady’ etc somewhat patronising.

I'd just like to add not all consultants do this. It is pretty outdated. On my team I would say most of the younger consultants don't do it. Some of the clinic letters I type are purely factual and don't include any opinions at all.

When I was a teenager, I had to see a consultant about something and he said "So, on the letter from your GP it says 'ItGhoul is a pleasant 14-year-old suffering from - ' Wait, a pleasant 14-year-old? I've never met one of those before." 😂

I hadn't thought about this (the whys/wherefores) but I recall my daughter being described as a 'big healthy girl' (she wasn't chubby! Just quite tall) when she was a toddler (and holding her poo). When she was a bit older, and referred for suspected still's murmur, her letter described her as 'pink and very healthy looking'. I had no idea that these comments could be code for her being well looked after 😂

I have a family member who used to practice medicine in Norfolk and back in the day (70s, 80s) they used to write NFN on some patients notes (Normal For Norfolk), which meant rather odd!

DH was once referred to as "a very charming gentleman who was mobile without a stick" by his oncologist. We laughed our heads off when we read it. He was 65 at the time, extremely lively and most affronted that this would be aging rock star could ever have been described like that. He's knocking 80 now and thankfully still just as mobile without a stick. DD4, a doctor, assures me that there are numerous mnemonics they use when clerking patients and they're not just referring to medical matters either!

I am guessing it means you were unpleasant. Damned by omission. Due to data protection (i.e. you can ask to see your records), they don't want to say anything outright negative.

I could be wrong and the person recording forgot to include the word pleasant or charming or delightful.

I've seen it used in education to describe parents.

I type these letters and it’s all very normal and habit! I wouldn’t read in to it! If you were very unpleasant, you’d just be a ‘lady’ or in my consultants case ‘woman’ as he doesn’t like the term lady! They save the rude comments about you in the comments specially for us admin staff!!

The short answer to this is no. 🤣How dare someone with a vagina question my authority. Even female consultants can be like this. The medical profession is full of misogyny and everyone knows it.

Strange, I read that as the mother is a pain in the arse as she thinks she knows best 😀

It possibly was the first time it was written like that, but my pushiness and reading saved my daughters life (her condition is rare so I don't expect everyone we meet to know it in detail) so it's definitely the latter now 😂

Vets do it too. My dog's record is full of "A very friendly character" and "Model patient who enjoyed lots of fuss and treats." Unfortunately one vet decided to quote me without the context (they were trying to prescribe something that I thought was not going to contribute to my cat's quality of life. A concern that, 3 years and many stressful vet trips, needles, pills and other tests and one dead cat later, I must say I feel was 100% justified. I should have listened to myself and not have let them pursue that line.) They quoted me as "O does not want to pursue dx because "she is an old cat so not worth doing X tests" which was an accurate quote but very much missing in context and made me look like I couldn't be arsed to do right by my cat because she was old. Unfortunately for them, it was precisely because I COULD be arsed with understanding my pet's health status and advocating for her best interests that I requested a copy of her notes and saw the note for myself. I'm still annoyed about that and whish I'd have said something, along with pointing the many pages after that comment that proved that I was very much the opposite of not arsed.

Thank you. Yeah, it makes me feel really uncomfortable and I don't understand what they're trying to imply.

I feel like I won't be taken seriously if they're on show so I've sat in appointments in the middle of summer sweating like a pig because I don't dare risk the judgement.

Why is it only used in medical notes though? Other customer based industries don't do this (or do they?) It's a little demeaning I think.

I remember years ago seeing a medical report for a legal case describing a woman as a 'well mannered unmarried secretary', my colleague was furious I remember. It's kind of funny too though.

The comment on your clothing is often part of a general assessment of wellbeing. For example someone appearing unkempt, unwashed or dressed inappropriately for the weather (for example no coat in the snow) may highlight failure of coping mechanisms. This might be due to mobility issues, frailty, cognitive impairment/ mental health problems such as depression or grief or lack of social support. It’s not a personal judgement but part of assessing a person.