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.)

Don't panic, there really is no universal code. Certainly not where I am
I'm sure individual people do their own codes but we wouldn't assume that you were tricky from that!

It’s not a compliment. It means you are agreeable. That may or may not be a good thing. It’s a judgement of you in terms of their own agenda.

Yep, that was a bizarre and ridiculous turn!

Often Dr's letters are the only record of an appointment

Yes 100% if people are outright agressive, threatening then you document that clearly

There have been times for example where I've been thoroughly shouted at. It's tricky to document that in a way that the patient has access to, but is still likely to come for their next appointment and not call up to shout at me some more. Often it's borderline, so for example I recently had a patient threaten to report me to management, cqc and various overheads, this is documented diplomatically in their letter because if I actually documented how the appointment went from my point of view she would probably never come back and miss out on medical care.

It might be different because I work in mental health where it's not uncommon to have volatility in appointments but we have to work hard to keep people trusting us

I would argue that you are making huge assumptions based on appearance. I put some make up on some days. Other days I don’t. Someone coming from work will look more ‘kempt’ than if they were coming frim
mucking out the horse. I have worked in health all my life so I understand why it’s part of the assessment, but I also have learned that it’s not that reliable. We sometimes notice ‘poor eye contact’ in the people that come to our clinics. Often it changes over time as they get to know us and feel more comfortable. It’s not an indication of health status necessarily.

That's odd, I've never had that on any of my letters. 🤔

As an NHS Consultant, I can tell you that can roughly translate the code as

"I reviewed this very pleasant patient" - we had a nice, productive chat, they listened and asked appropriate, reasonable questions and came to a collective plan
"I reviewed this pleasant patient" - All was fine
"I reviewed this patient" - ......

Hope that answers the above question.

My consultant described me in a letter as being “very clued in”.

Those consultants do often seem to speak as though from the Victorian era.

Still ... I would be chuffed myself at that description. Maybe frame it and present it to your son as his Christmas gift?

It's when you have "Thank you for sending this patient to me" in the beginning of the letter you know the Consultant thinks you're a pain in the arse. I'd like to clarify that it is not a letter I have received about myself but one I've seen about a patient.

Absolutely it shouldn't be the only thing but it can be a hint

Make up is a great example. I rarely wear it so it's not a warning sign for me if I flip flop. If I see someone who wears make up in my last 6 appointments and suddenly isn't wearing any, then it's worth making sure that I ask about mood a bit more. I'm not going to section them based on lack of make up, or decide they can't be suicidal because they are wearing make up

It's probably important to note that I work in mental health where sometimes people might say they are OK but are actually struggling

I know the first thing that confirmed my concerns about my DM having a dementia diagnosis was her self care. As someone that knew her well, I knew that it wasn't normal for her and luckily her doctors also twigged it. She told me she was showering the same as always but I could see she wasn't.

My husband was a “very pleasant” gentleman in a consultant letter recently - I however I was just “his partner”

My vet surgery has similar, they put a little crocodile icon on the record of aggressive/potentially bitey pets that needed to be muzzled for examination. My old dog had one and I joked that it'd be useful for some clients too - turns out they do 🤭

What I really don't like is when they say or write " thank you for coming to see me".
No I have a medical issue for which I "need" to see a HCP. Not to please the HCP or do him/her a favour for which I need to be thanked for.

My DC was "I saw youngharrisinparis in clinic today" to be fair they were really badly behaved in the consulting room so I don't blame them for dropping the descriptor.

This made me snort 😂 I too am a very pleasant lady. Till I’m not. Then I’m a giant pain in the arse. I take great pride in it.

None of my consultants had ever said that about me.

Do Scottish consultants have a different one or what's the code for boot faced annoying old bat?

Totally appreciate that. I guess what I do is write to the person themselves.

Dear Mr X,

‘Thank you for coming to see me regarding XYZ difficulty. I am writing to summarise our meeting/consultation and to XYZ, but let me know if I have missed anything that you think is important.’

Then I’d describe the issue and what was decided highlighting what other professionals need to know. For example;

‘As you know, we agreed that a referral to XYZ might be helpful/is needed and I have sent them a copy of this letter. (It would also be in bullet points at the top so the service/professional can easily tell that’s it’s a referral or whatever).’

‘I am sorry that you found XYZ difficult. I understand that you are not happy about XYZ. I am really keen to support you with this and I could see how upsetting it was, (or I could see that you felt really cross/angry about this) but I do ask that you refrain from shouting at me in future meetings. This service has a zero tolerance policy on aggressive behaviour and I enclose the information about that. I do understand, however, why you were so upset and I would really like to do my best to support you with that.’

‘I do hope that XYZ improves/works/reduces symptom etc but please do come back if you find that XYZ happens/it doesn’t work etc’

So empathy and understanding, respect and a clear boundary and then empathy and compassion again. A boundary sandwich. Facts only. No personal judgement- just the behaviour that needs a boundary. It’s how I would want to be treated if I got overwhelmed and lost it or if a relative did.

Doesn’t work every time but you can’t please all of the people all of the time.

I write that. Or ‘It as good to meet you in XYZ clinic today.

May be I should re think the thank you!!

Aw all my doc letters ever seem to say is ‘I saw Jayne in clinic today’ or ‘Jayne is doing well with x issue’ etc!

Same for my kids’ letters, I’ve got 2 being seen by hospital long term and they just use their names.

I think doctors speak like this to tell other doctors whether a patient is reasonable, difficult, etc.
In my dad's letters, they always call him a very pleasant gentleman.

That's very nice. I was recently described as "......is a single woman in her 40s who lives alone with her cat". 🤷‍♀️

Yep this. You’re not going to cause any problems for them.

normal consultant speak. Decoded it means you were nice to consult with and didn’t give them any shit.

I think it’s awful. I work in health and I don’t want the people that come to me to feel that they have to just be agreeable and compliant. I want to hear their thoughts, worries and concerns. I am also aware that many people have had awful experiences with health care professionals that have left them traumatised and fearful so I fully appreciate that they might be on edge or want to double check things or even get a second opinion. I won’t tolerate aggressive behaviour but I’ll deal with it by trying to understand why as well as putting a boundary in.