To find my report from breast clinic condescending?

[duletty]

I’m 44, had breastfeeding pain for a few months and then found a large lump on the underside of my arm near arm pit.
Gp arranged a quick appointment (was three weeks when usually a two week wait)....
Any way after mammogram and ultrasound they said it was cysts and calcification, so all good.
Got letter today outlining results and it said:
“Saw the this delightful lady in clinic today”......etc etc
I find this language unprofessional and it pissed me off that it was shitty code like a child’s school report.
I have to write reports for EHCPs and use appropriate professional language do it set me on edge.
Am I being precious?

I’ve had ‘delightful’ and ‘charming’. It does remind me a bit of my old school reports. When I used to teach we weren’t allowed to write personal comments about the students, only subject specific feedback, which I always thought was miserable.

But isthisfinallyit would it not be helpful for the doctor to say they “saw Mrs x who unfortunately seemed to be very frightened by her clinic appt”? Or Mr Y who is obviously exasperated by his progress? We’re not idiots - we understand people often aren’t thrilled to need our services. But it lets the next person know a bit about the person they’re treating.

Yes, you are being very precious

*This is standard and I have no idea why anyone should be offended by it. The alternative completely factual list for example:

Name:

Investigation:

Diagnosis:

Is far worse.*

I'd highly prefer that. It states the facts, which it should do. I shouldn't be treated in any way differently because some other medical professional called me delightful or not in a previous letter.

It is where I work!

Every workplace has their own 'normal language', the medical profession is no different, and what is usual for one workplace is not for another. I did work in an office where twats were called twats, but that was many, many years ago.

OhTheRoses you and I have discussed the name thing before (I name change a lot)

I personally refer to myself as Dr Id and to my patients as Mrs X or Mr Y unless they ask me to use their first name (which they sometimes do). I do not allow patients to use my 1st name and I do correct them if they try to as I view it as a boundary issue. We are not friends it is a professional relationship.

When calling a name in a waiting room I just use both names eg Emily Jones as otherwise there is a risk of seeing the wrong Mrs Jones (has absolutely happened to me). Once in the room I say Mrs Jones.

However society overall is becoming more informal and I notice that my junior Drs often introduce themselves by first name surname or even just Dr first name rather than Dr Surname. Some have learnt to do it because British people have trouble with eg Sri Lankan surnames and therefore they go with Dr Dev rather than Dr Sivasumanyathan. Understandable I think.

We are all taught not to refer to patients as love etc and I cannot imagine myself doing that. I don't notice people using 1st names without permission certainly not in outpatients but I accept that is your experience.

But they never do write I saw Mrs Jones. They write I saw Jane Jones, whilst adding their own title to the signature. It is so very reductive.

@BarbaraofSeville

Sorry, but that's dreadful. Not professional at all. Reports on this sort of thing should be factual and medical. I do wonder if they would write in a similar manner about a man who was having tests for testicular cancer?

Yes, they would. The bloke was described as a “very pleasant gentleman”. You can tell they don’t live with him.

It’s when you aren’t delightful/pleasant you want to worry! As an ex medical secretary I can assure you, we know when the consultant isn’t happy with you. They generally have their own style and dictate very quickly at the end of your consultation to ensure all of the facts are correct.

If you complained the next letter would not say ‘delightful’ and every other doctor reading it would know you are of a complaining precious disposition

I have no wish to use a Dr's first name but if they use mine I find it wholly unacceptable if they think I'm going to address them with a title. Usually I correct them and ask them to note I wish to be called Mrs Roses but I shouldn't have to.

We have a Sri Lankan Dr at our practice who introduces herself thus: I'm Dr Julie, it's easier because none of my patients can say my Sri Lankan name properly. My surname is a very very complex one, I accept people get it wrong, I don't say oh you can call me Mrs Cressida because you will struggle with my complicated surname. But if my Dr wants me to call her Dr Julie because the ignorant people can't say her name properly, she may call me at the very least Mrs Cressida because I am not her subordinate.

I think you have missed the point about equality. If another human expects to be addressed with a title then they should jolly well use the patient's and to do anything else is rude.

I've had a lot of hospital letters, clinic referrals etc over the years and this is very standard language

But most people don’t want that degree of formality, you’re an exception @OhTheRoses.

My dad’s last visit to A&E took place when he was 99. The consultant introduced himself as Taj and addressed Dad as “Sir”. Que laughter and “None of that nonsense, I’m George”. I don’t want to be called Mrs Human, thank you.

I only want and expect to be called Mrs Roses when the Dr expects a title. In your father's situation I'd have said do call me Cressida. Had the Dr introduced himself as Dr Jones, I'd expect him to call me Mrs Roses and not to use my surname.

I'd have no issue with Theld as she (or he) addresses the patient with the same level of respect she expects them to afford her which absolutely the right way to do things. Although when she calls me in for my appointment I'd prefer her to call me as Mrs Cressida Roses (not my real name but same genre).

I work in a very hierarchical environment but nowadays everyone is on first name terms, even the profs.

I'd be pleased the cancer results were negative rather than questioning why certain adjectives were being used.

I'm in remission from breast cancer ~ the letters usually say 'this pleasant/very pleasant lady ' . I really don't mind as it's unimportant.

@Moreisnnogedag

But isthisfinallyit would it not be helpful for the doctor to say they “saw Mrs x who unfortunately seemed to be very frightened by her clinic appt”? Or Mr Y who is obviously exasperated by his progress? We’re not idiots - we understand people often aren’t thrilled to need our services. But it lets the next person know a bit about the person they’re treating.*

By doing that you are directly trying to influence the care of the next doctor on the basis of a short consult on a given day. You don't know this patient but your words can have far lasting consequences. Maybe the next doctor would think she needs a pat on the head for being frightened, and tgerrfore doesn't investigare enough. Or Mr. Y had a good reason to feel exasperated on that day or during the consultation with you. It shouldn't mean that you get to influence the care beyond that appointment.

And whatever you write does have influence, I have type 1 diabetes, some doctors will not look into any health complaint that I have because it's "probably just my diabetes" which is a very dangerous thought process to have (and one that diabetics often complain about). I would complain about a referral letter that would state my diabetes without it being relevant.

Another example: after I had my stillborn I needed therapy for my PTSD. I have recovered from that but it is being brought up at every antenatal appointment even though I have said multiple times that I'm doing well now and if I need help I'll ask for it (just like last time). My current pregnancy appointments should not start every time by referring to my stillborn. I'd like to have a different experience now. Is it well meant? Yes of course but it's not exactly helping me to keep rubbing my nose in it.

So I'd rather that letters were factual, at least you then get the same standard of care as everyone else.

I work in healthcare and read a ton of these letters. People are usually "delightful" or "pleasant". It's so standard that when a consultant wrote to my GP about me and didn't include one of these adjectives, I was vaguely insulted and started questioning my likeability!

Worked in a hospital for many years..... Any comment about you being a pleasant patient actually means you are "normal".

If there is no such statement it means means you are NOT a normal patient, which the doctor wishes any other clinical staff to know, without writing it down specifically. Given that I have witnessed some patients being exceptionally rude and difficult to medical staff, I am not surprised.

@BarbaraofSeville

Sorry, but that's dreadful. Not professional at all. Reports on this sort of thing should be factual and medical. I do wonder if they would write in a similar manner about a man who was having tests for testicular cancer?

No it isn't 'dreadful' get a sense of proportion. Absolutely standard medical letter phrasing. My mum one complained they had only described her as 'this nice lady'

Oh for goodness sake you are having a joke surely aren't you?

How on earth do you find the time or energy to get worked up about something so minor that isn't offensive in the slightest?

I type consultant clinic letters as part of my job and many letters are started like this. I've never ever had or known anybody to get offended about it, just you.

I get this or 'very pleasant lady' on all of my letters. It's standard I'm really surprised you haven't encountered it before

How can anyone be upset and want to complain about being referred to as delightful in a letter? You must really live a charmed life if this is a huge issue to you. I work in a hospital and as others have said, this is completely standard, it means you’re nice and normal.

I was once a ‘please take and pragmatic lady’.
We’d had a long conversation about how treatment X wouldn’t completely fix the issue, it would probably come back in the future, and I was fine with that and didn’t kick off that there wasn’t a handy ‘cure’.

I also got ‘interesting’ on a letter after he rediagnosed me with a condition I thought had been something else for 25 years. Bit of a shock for all concerned!

I give you the following from my spouse’s most recent and unfortunate hospital appointment - this letter from his consultant to his GP and sent to him -

“Last week I met (Mr Name) - an engaging and youthful IT professional to discuss with him the progress of his (insert deeply embarrassing personal bodily ailment). This charming young man has displayed great fortitude so far in dealing with the doubtlessly difficult everyday situations this has presented him with.”

You should try ophthalmology letters.

No mention of whether you are pleasant, charming or frankly gruesome, 3 lines of abbreviations that even google doesn't help with and makes no sense to your GP either and then a statement about eye drops.

This will invariably be different to what was said to you in clinic.

DH has had this for 8 yrs now and counting and every patient letter I've seen from opthalmology has been exactly the same.