I am a "very pleasant lady"

[HauntedBungalow]

... according to the consultant who wrote to my GP following an appointment. It says so on the first line of the letter.

I was feeling quite chuffed about this but when I told my cynical piss taking 21 yo son he said it probably meant I was a bit dozy. Surely not!

Does anyone know if "very pleasant lady" means fragrant and nice, or if it means thick?

I've obviously disinherited the son, regardless. (Not so dozy now am I? Twat.)

I agree. I always ask patients what they want to be called. They are not my friends so I should not assume I can use their first names. It’s old fashioned and presumptuous.

I'm sure this has been said already (haven't read the whole thread) but this certainly used to be part of a doctor shorthand. I temped as a medical secretary when I was a student, and there was a whole list of phrases which would communicate what sort of patient they were dealing with. In the department I worked in, 'very pleasant' meant the patient was straightforward, polite and actively engaged. 'Pleasant' was similar, but possibly not quite as clued-up or engaged. No qualifier at all meant they were a bit of a pain. There were lots of others, meaning anything from 'really struggling' to 'thinks they know everything.' It might well have changed since then, although I did once ask a doctor who was about to dictate his referral letter in front of me whether they still did it, and he grinned, said 'not at all' and then carefully emphasised 'very pleasant lady' as he dictated!

I became a consultant in 2000. I have never needed or been tempted to use these kinds of acronym. There is a certain kind of doctor that revels in immature medic-speak. They were never my friends at medical school.

It is “I saw this patient in clinic today” if we leave out the “pleasant” it usually means the patient was far from it 🤣

100%

I never label the people I offer healthcare to as pleasant. Ever.

I was going to say - I don’t remember ever having read this on any of mine (which I know implies that I’m a horrible cow to deal with - I’m really not 😂, I usually manage to make a weak joke or two to diffuse any anxiety I have, particularly if it’s a potentially serious issue and the medical person laughs or smiles - I know that makes it sound worse! But I certainly don’t behave aggressively or rudely) I seriously didn’t know this was a thing.

When I first read the OP my first thought was - ew, that’s a bit over-familiar, what’s that got to do with her medical complaint?! Sounds very archaic and patronising.

Also, doesn’t it make more sense for the GP to write that to the consultant if it’s to warn them about negative behaviours? Surely the GP will already be aware so why would it be necessary for a consultant to report back on a patient they’ve presumably already seen to refer them?

As a GP the only non-clinical descriptive word I use is “challenging”. And this would be for patients who are just awful - rude, abusive, threatening, prone to swearing at staff, walking out of appointments, slamming doors etc. It’s a way of warning clinical staff who may see the patient to be prepared for a difficult consultation.

The vast majority of people are amicable. Every so often we will meet someone who is rude and aggressive but there is usually a backstory - unfortunately there is no time in a 15-20 min consultation to delve into this. We are “trained” to put up and deal with anger and rudeness but it grinds you down.

Mine say pleasant nurse. Meaning don’t try to fob her off and you won’t bamboozle her with science 😁

Some of you are seriously overthinking. If you think the average NHS GP or consultant has that much time to analyse your personality you’re a bit self obsessed.

And if you’re an arsehole or violent they have better ways to flag that than bloody coded words.

I had a breast lump when I had a 3 month old baby. Asprairion, biopsy and ultrasound showed nothing Mamogram couldn't be done because I was breastfeeding. I asked if i should stop so it could be done. Consultant said no need and he'd review in 3 months. I had given family history of my grandmother dying of breast cancer. At the follow up appointment I asked for a lumpectomy. The Consultant said there was no need and the lump would go on its own when I stopped feeding. I insisted and had the op a week later after stopping feeding. It was cancer and I needed further surgery. The next day I went to see my GP. She told be she had booked an appointment for me at another hospital out of our area with a Consultant she knew saying that she thought I may not have confidence in the original Consultant. This was in the days before patients automatically received copies of letters. I looked confused as I hadn't even thought about that. She showed me a letter which said I was a paranoid mother of three who should know about breast changes during lactation. I had insisted on an unnecessary lumpectomy and wouldn't listen when told I would have a pointless scar! It was the GP who lacked confidence.

I remember as students being encouraged to used certain phrases in referral letters to forewarn colleagues. So most would be pleasant lady or gentleman, occasionally informed suggesting they knew more about their condition than we did. For difficult patients you would use a straight forward approach.
Nowadays it’s all done online so much less formal, although I still like to compose a proper referral. It is important, for safeguarding reasons to make it clear if a patient needs an advocate. Patients receive a copy of all correspondence so you need to use subtle phrases to indicate if patient has memory problems. It’s obviously easier if they have a formal diagnosis of dementia. A comprehensive medical history will often give the consultant the info they need. Patients with mental health problems are easier to identify by the drugs they take.

That's not the point. The point is the highlighting and heightening of the power differential that's implied in the act of assuming a right to judge/label someone's personality/demeanour, in the third person, to another professional.

I got a 'delightful lady' in the letter from the consultant I saw about my alopecia. Which I found rather distasteful actually since he barely spoke to me for his £270.

Surely 'pleasant' is a subjective term. Somebody needs to have a word when training takes place. It sounds positively antiquarian.

This. Well said.

If a patient is pleasant I will describe them as pleasant. If they aren’t then tend to leave out a descriptive. If they are knowledgeable about their condition the consultant will know to use more complex language. It’s often useful to give the consultant an idea of their profession. Social history is just as important as medical history in diagnostics, we’ve all seen “House”.

I got 'talked in long sentences' on gp report this week, what the chuff does that mean?

Pompous and overbearing.

Yes they are. I say that from long experience.

Surely there was absolutely no need to write this?

Dh and I were “this charming couple”, to be fair looking back we probably were.

I think it depends on what they were talking about.
If it's part of a neuro, developmental, mh exam then possibly worth documenting

If not then it's odd and worth questioning!
Often notes are short so it's an odd thing to comment on if they aren't concerned about something cognition, speech wise or something like mania