What exactly are you expecting me to do for you?

[orangeshoebox]

aibu in thinking this is the most useless sentence said by a healthcare professional?

who has decided that this is a good thing to say to patients?

It sounds almost identical to the rather stroppy and confrontational question "What do you expect me to do about it?" so I would feel it was dismissive and as if I shouldn't have taken the doctor's time. I would feel upset and wondering where to turn for help if this was the doctor's attitude.

As a HCP seeing, treating and discharging patients, these days were being encouraged to consider and use the “ICE” acronym in consultations with patients. So what are your Ideas, Concerns and Expectations, it can be very useful in ensuring the patient feels heard and understood, and it helps the HCP to quickly get to the crux of the matter. However, there’s a skill to asking it!

I wholeheartedly agree. I've got a friend who went to her GP for symptoms of depression and they asked this. Another friend went with digestive problems and they asked this. I've been to the GP and they asked this. You have to now know what med or referral to which service you are seeking, ridiculous.

It’s like an infection at my local hospital at the moment the way this phrase is being bandied about in a passive aggressive way, accompanied with an eye roll.

Took someone to hospital recently as the GP had been concerned with symptoms and blood tests results and upon examination believed he was bleeding internally. GP phoned ahead, wrote a letter with concerns etc. Waited at A&E for 12 hours to be told test results had been lost but not to worry he’d be admitted within the next 40 minutes. The person in question is non verbal and I needed to get back for medication and to pack a bag for him. Arranged for another person to relieve me. There was a 20 minute gap where he was unattended whilst he waited to be moved to the ward. Other person arrived at A&E to discover he was gone. Panic ensued. He was sent home in a taxi with no details whatsoever about what had happened and without vital medical equipment. No one contacted me to tell me he was being sent home and not to the ward. I would have stayed and driven him home!

I called the A&E department to ask if there had been a mistake and to see why he had been sent home. The nurse on duty was awful and kept repeating “and what EXACTLY are you asking me to do?”...Erm let us know what’s wrong with him? How things changed so quickly? What his test results said? Why a vulnerable young non verbal adult was sent home? “I can’t tell you any of that. I don’t have his notes. The GP will have them electronically - ring them on Monday.” It was Friday. Please can I speak to a Dr, perhaps one that attended to him? “What do you think that would achieve?” I need to get his controlled drugs back. “I’ve no idea where they are and we don’t prescribe.” She was just horrible towards me at a very worrying time.

As it turns out it was all a mistake and he was neglected. He was indeed bleeding internally and nearly died from an obstruction. Obviously had to be readmitted. I was treated like a freak and an annoyance for questioning what had happened when it was clear there had been some mistake.

They do it a lot in mental health. Which is annoying because we all know damn well that what they can offer is a tiny subset of what might be helpful. Conversations go like this:

Jobsworth nurse/social worker/support worker: "So what kind of help is it that you want?"
Patient: "What kind of things do you offer?"
JNSWSW: "Well, what do you think would help?"
P: "Um… I don't know what you're able to do."
JNSWSW: "What is it that you want us to do?"
P: "Er, well, I'm not a doctor and I don't know what's available in your service but what helped last time I was this unwell was weekly meetings with a CPN, meds reviews every couple of months, and a course of CBT with a psychologist."
JNSWSW: "No. You can see a doctor in six months (if we don't surreptitiously discharge you) and in the meantime here's a pamphlet for the Recovery College so you can go and do a course in Mindfully Enjoying Herbal Tea."

It's really interesting that this is apparently common. I heard it twice from different doctors in relation to a current problem. I felt dismissed, belittled and upset; so I left without my issue being resolved and am trying to just live with it. I presumed that was their intention.

Oh I thought it was just my GP being daft, I had no idea they're told to ask this! How ridiculous. When mine asked me I replied "I want you to either tell me my symptoms are normal and will go away, or I want you to send me for a scan." He said "well I can't say your symptoms are normal" so I said "you'd better send me for a scan, then." I felt like he should have been able to figure out what to do himself! I ended up needing surgery.

What exactly are you expecting me to do for you?

To me it conveys that the doctor finds the patient’s very presence unreasonable.

All our exams basically ram it down our throats to ask this very question

Then it's a pity the examiners have so little sense or compassion. They'd have no doubt loved my ex GP (funnily enough the one who always had plenty of appointments available) who refined it into an abrupt "what do you want me to do about it?"

"What exactly are you expecting me to do" could so easily be replaced with "Now, how can I help you best?" if just a little thought was applied … and it even takes fractionally less time to say

There's so much emphasis on patient choice and autonomy that it seems to be forgotten that while we must always be free to make our own decisions, when we're ill we sometimes want a bit of a guiding hand from someone who knows what they're doing. Informed consent first requires you to inform us. We need all the relevant information, including, if necessary, some proper medical judgement from someone who's actually trained to use that information to come to good decisions.

It's perfect for the lazy HPC.

If it happens to me i'll simply say ''i don't know what to bloody do about it that's why i've come here!

tbh I'm that this is part of training.

who benefits from asking a question like this? doesn't look like it's for the patient's benefit.
this question is not patient friendly and seems to be used inappropriately in some cases.

my 'favourite' situation was at my gp. they refused to prescribe meds to my dc as per the consultant's care plan.

sounds very mocking to be dismissed like that.

If they have to do this, why not "Have you had any thoughts already about what this might be, and what might help? Any worries?" Open it up, but without thrusting diagnostic and clinical responsibility on to the patient.

It's really annoying when they shove it all on to the patient, immediately followed, a lot of the time, by an almost scornful reaction because the patient's got it wrong or asked for something they can't have.

Ohhhh, that's where this comes from!

The GP said this when I was in with DD2 who had weight gain issues (dropping centiles). I just assumed he was inexperienced and didn't really know what he was doing! Told him what I wanted and made a mental note never to see someone with so little gumption again.

Although tbf, the dr I saw phrased it as "what outcome were you envisaging from this consultation?" Which is a heck of a lot less aggressive than the OP!

I feel lucky that the last time I saw a doctor she was running very late and in a huge hurry as well as very uncomfortable as it was during the recent heat wave. She was in no mood to waste time. No sooner had I told her what was wrong than she was typing furiously while saying "You need x-rays, I've just sent the details to the hospital, go to radiolology any time next week and they'll do them" (too late for that week as it was Friday afternoon).

I'm so glad that she didn't use the phrase in the title to me, but knew exactly what was required. I would have questioned her competence if she'd asked me what I expected her to do. As it was I couldn't have been in the surgery more than a couple of minutes and I hope that meant she was able to catch up a bit as other patients may well have needed more time with her.

Radiolology — like radiology but for people with interesting items up their bottoms.

I refused to see a doctor again after taken an ill child in and being asked, "what do you expect me to do about it?"

I thought he was so rude and was questioning why we'd brought her in!

I am gobsmacked this is part of the training

YANBU. A couple of years ago, a HCP said this to me then interrupted my attempt to answer by repeating themselves. After the fourth time he did it in the space of a couple of minutes I just got up and walked out because I realised he had no intention of letting me finish let alone doing anything at all. I asked for a different HCP and they actually helped.

ScrewLiterature Oops! That's what I get for not going to get my reading glasses before posting. Radiolology makes me think of a department for people who always get the giggles when they have an x-ray. (I'm still not wearing my glasses, but I think I got away with it this time) .

'I am expecting you to do your job and use your medical knowledge and skill to figure out what is wrong with me. Thankfully, I was not expecting empathy but functionality is ever a bonus in such situations.'

What a stupid way to ask a question. You'd think The Powers That Be would have figured a better way to be to use words, if they could be bothered, which apparently, many cannot (or are incapable).

And c'mon. If I went to my clients, colleagues or supervisors with trollop like this or 'I don't know' when I'm being paid to figure it out I'd be sacked.

To clarify, im not defending it, but as PP have said, it’s supposed to make it more patient centred- it’s how we are now taught to consult and the ‘traditional dr tells you what you need’ method is seen as wrong. If you don’t do it, even with superb theoretical knowledge, you would unequivocally fail your training!!

However the phrase examples given here are terrible! It’s sad to hear that it makes people question competencies tho, as if the Dr is asking, chances are actually they are more likely to be sensitive to your ICE or they wouldn’t be bothering to ask at all! Hopefully I manage to do it in a way which comes across ok! The reason I still continue is that, as I said, about 1/3rd of times it reveals something that wouldn’t naturally have occurred to me and then at least it gets addressed.

I still think this phrasing is problematic though.

I think the whole concept is problematic. If I go to the doctor because I have something wrong with me (why on earth else would I go to the doctor's?!), then I want the doctor to use their medical knowledge to diagnose and treat what I have. If I wanted to have an exchange of ideas and thoughts, I'd go to a bloody philosophy class.