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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

What exactly are you expecting me to do for you?

113 replies

orangeshoebox · 17/08/2019 13:18

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?

OP posts:
CurlyhairedAssassin · 18/08/2019 10:25

I’m really glad I read this thread. I had no idea that new GPs were being told to do this. For a good while now I have been avoiding younger GPs because all the newly qualified ones, by asking this question virtually exactly as OP has phrased it, come across to me as totally out of their depth and like they haven’t got a clue where to start. They say this immediately after I’ve told them what my symptoms are so it’s very off putting when they don’t even go straight into a physical examination but just ask that. Of COURSE you are going to feel like there is a suggestion that you’re making the symptoms up, or exaggerating them, that the problem is too trivial to take seriously, that you’re wasting the GP’s time (which, by the way, we know is precious), or that they don’t have the first clue where to start.

If I go to an older more experienced GP, I know I’m going to get something along the lines of “what have you come to discuss with me/see me about today?” Or “how can I help you today?/what can I help you with?” Then I tell them my symptoms and concerns, they probe further asking about any family history etc, do a physical exam, tell me what they think it might be and what their suggested plan of action would be eg a prescription or further investigation and AT THAT POINT ask me my thoughts on their suggested plan and did that fit with what I was hoping for? Also at the end “is there anything else I can help you with?”

I think from reading this, maybe new GPs maybe don’t have the confidence yet to go off-piste slightly from how they’ve been trained to say things. I’m sure eventually they’ll realise that it needs to be phrased slightly differently and used at a suitable point in the consultation not as soon as you’ve told them some symptoms. That’s if they have any patients left other than hyperchondriacs who are happy to see any GP, in which case it would be appropriate to carry on saying it in an abrupt way at the start of the consultation! Grin

Seriously, though, not everyone has a natural bedside manner. Not every young GP has common sense when it comes to people skills. They may be the type who was really clever at school and flew through all their exams with top grades, making them extremely knowledgable on the clinical side but it doesn’t mean that they automatically have the people skills to match. I do think that needs to be emphasised during their training. I mean, what happened to “first do no harm”? If you’re already getting people’s backs up so much within 2 mins of getting in the room that they go away not having had their issue resolved, or in mental health cases, considering that they are unhelpable and consider suicide, then you are doing harm!!

Whosorrynow · 18/08/2019 11:03

Of course the underlying aim is laudable, but the person tasked with implementing this underlying aim clearly did not have laudable intentions, why else would they phrase it in a way which frames the client as an ignorant, unreasonable, undeserving, time waster?

Did they mean to be so passive aggressive?

KaySarahSarah · 18/08/2019 12:38

Curly I have been wondering out loud to friends and family the last couple of years why young doctors seem so "limp".

timshelthechoice · 18/08/2019 12:39

I'm glad I read this, too. I'm being investigated for stomach ulcers (or whatever else it might be) and it was the practice nurse who first brought it up when I told her my symptoms because I had no idea it could even be from that and wouldn't have brought it up had I been asked 'What exactly are you expecting me to do for you?' Not everyone uses Dr Google and as it's fallible I mean, isn't that why people go and see an HCP often enough, because they don't know what the hell is wrong with them?

TemporaryPermanent · 18/08/2019 12:58

It sounds like the idea of ICE is fine but the execution is flawed and sometimes assessed in a way that's more about ticking the box than genuinely trying to explore a patients world view. What a shock.

Possibly a more explicit way of talking about it would work - eg 'i need to ask you what you expect from today now'?

slipperywhensparticus · 18/08/2019 16:43

I hurt my back quite badly doing something stupid so totally my fault the dr asked me what I wanted her to do my response was stronger painkillers and reassure me this is going to get better soon? She laughed and wrote me a script for painkillers

whattodowith · 18/08/2019 17:30

Happened to me lots. I took my first born to the GP’s once as a baby because I was a typical anxious FTM and didn’t know what was wrong with him. She literally asked me what I expected her to do about it and I wanted to burst into tears! I felt so demeaned. It’s such a lazy response.

AtLeastMyDogLovesMe · 18/08/2019 17:47

I had this said to me a few years ago and it has bugged me since, so thanks for this thread OP as I didn't know they are being trained to say it! I hadn't been to see a GP in about 5 years and that comment made me feel as though I was wasting their time. I had a one sided aching pain in my throat/neck which was beginning to worry me as it had been going on for months. I could also detect a slight swelling in my neck on that side (GP couldn't). When the GP said "So, what were you expecting me to do today?" in an off-hand manner, I replied rather tentatively "I thought maybe a bloodtest?" I was sent away with a leaflet about neck exercises, and no follow-up.

I was pretty upset and decided to pay for a private MRI, which revealed a cyst on my thyroid.

Surely the good old fashioned "Now, tell me, how can I help you today?" would be far less dismissive?

gobbyone · 18/08/2019 17:53

Bloody hell, this is training?

I thought they just couldn't be arsed!

I replied that I'm not a doctor, could you just make it stop hurting?

Namenic · 18/08/2019 18:12

I think maybe they are looking to see if someone is particularly worried about a specific disease or wanting a particular investigation? It’s hard to fit everything into a 10min appt. they have to make a tentative diagnosis in 5mins and then explain about further treatment and follow up in the other 5 min plus record consultation

impostersyndrome · 21/08/2019 19:33

I’m so grateful for this thread. As someone who lives in constant fear of being seen as a hypochondriac, even though I’ve had some serious illness, and as someone who takes things very literally, I find this formulation very problematic. If anyone is reading this who can influence GP training, for goodness sake, please feed it back.

lljkk · 21/08/2019 19:51

This was said to a relative & I think was exactly the right thing to say.
Relative has T2DM.
Doc asked loads of "Are you doing X..." questions about self care.
X was things that can slow progression of T2DM.

Answer was always No. Relative did nothing to help self.
"What do you expect me to do" was the right question for doc to end on.
Relative's wife wanted to kiss the doctor for saying it.
Relative just wanted higher medication & to continue ignoring his T2DM.

orangeshoebox · 21/08/2019 19:57

lijk in that case and at that stage of the consultation it's appropriate.

I object it being used in a 'go away' kind of way at the beginning of the consultation or without any options given.

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