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 am at the bar and would be disciplined/raised eyebrows/spoken to (and I am senior) etc in almost all circumstances I can think of if I used those types of phrases/words in writing to or about a client - it would be highly unprofessional.
I remember when I first saw ‘delightful’ i stared at it for ages and wondered if it were some kind of medical profession code.^

Christ yes. I can’t think of any other field where this would be acceptable, let alone vociferously defended.

Let alone one where there is a power differential /gatekeeper to service provision role.

Let alone one where there is a power differential /gatekeeper to service provision role

Perhaps because there is no other field which is free at the point of delivery. A barrister’s fees are ££££ so you can be as entitled as you like about their behaviour. Ditto if you have private health care.

Perhaps because there is no other field which is free at the point of delivery. A barrister’s fees are ££££ so you can be as entitled as you like about their behaviour. Ditto if you have private health care.

I’m not a barrister. I’m simply saying I can’t think of another service - public or private sector - where it would be considered approve or entirely professional to make a personal and irrelevant comment in a professional letter - complimentary or not.

I’m interested that you feel the fact it’s a public service makes a difference though - should people be less respected or treated in a less professional manner because they’re not paying directly for it?

I can’t think of another service - public or private sector - where it would be considered approve or entirely professional to make a personal and irrelevant comment in a professional letter - complimentary or not.

I totally agree with this. It seems so out of kilter with how all other business/services are conducted. You’re there to be diagnosed, not endear yourself with your personality.

I can’t think of another service - public or private sector - where it would be considered approve or entirely professional to make a personal and irrelevant comment in a professional letter - complimentary or not

Totally agree. But everyone was up in arms about not making nice comments so the habit has died hard.

A lot of my clientele in one job I do aren't delightful so it's easy not to say it. And once you stop, it becomes an effort to write it for those who are and you realise it looks silly.

I think the great majority of doctors would be very shocked to find that their patients thought it was some sort of code, or patronizing, or unprofessional though. They genuinely think it's the right way to write a letter and they are doing a nice thing.

I can’t think of another service - public or private sector - where it would be considered approve or entirely professional to make a personal and irrelevant comment in a professional letter - complimentary or not.

I totally agree with this. It seems so out of kilter with how all other business/services are conducted. You’re there to be diagnosed, not endear yourself with your personality.

Well no because other indistries generally are not related to your body. Its about not making you a meat market. Showing you are a human being and not just a body to discuss. A lawyer might not compliment a person because they are not discussing your body. A surveyor wouldnt need to compliment you as a client because they are not surveying your body.

I worked with a consultant's PA and she always typed such stuff. She said it was mainly to fill the page.

Dear Patient X
You're fine
Kind regards
Mr Y

Such short notes were deemed to be too short, peremptory. So they added some fluffy sounding pleasantry to make it look like someone had taken time to respond.

But I also know she had her own code that determined which specific but if fluffy pleasantry was added, as guided by the notes the consultant gave her.

Well no because other indistries generally are not related to your body. Its about not making you a meat market. Showing you are a human being and not just a body to discuss. A lawyer might not compliment a person because they are not discussing your body. A surveyor wouldnt need to compliment you as a client because they are not surveying your body.

Except that of course a lawyer may be talking about your body, depending on the case in hand.

I don’t really feel like that’s relevant though. There must be a way to convey that you’re dealing with a human being without an apparently meaningless platitude about how you judged their demeanour on a given day.

As a suggestion: ‘I discussed with Ms Radlett the choices between x and z, and agreed you would discuss this with her further/ we will pick it up at her next appointment.’

Well no because other indistries generally are not related to your body. Its about not making you a meat market. Showing you are a human being and not just a body to discuss

I personally don’t see how adding meaningless drivel about personality (which you are not there to discuss) adds anything or achieved what you think it achieves. Polite and formal is much more appropriate in my eyes.

Standard hospital speak for not an annoying know it all.
I saw it written about me once - I'd been furious at the appointment and demanded an explanation of why the consultant had prescribed medication that was contraindicated with something else I was taking at the time.

His explanation - he (of course it was a he) didn't read the patient information leaflets.

Yes, very unprofessional - and kind of 1950's

You should be thanking your lucky stars Mrs instead of bleating about crap.

Standard hospital speak!

I don't like it when they do this. It indicates that the clinician is being judgemental rather than remaining objective. It's also rather patronising. Someone like me - autistic - will often not come across particularly well, even though I'm a reasonable and pleasant enough person. I wouldn't like to think that it would influence my treatment, but it probably would in reality. I'd be upset to think that a doctor was passing judgment on me - they have in the past - and passed that judgment on to another clinician in the way they refer to me in a letter. In reality, nobody knows anything about my nature as I instinctively hide what I am. I expect people with trauma and mental health issues feel much the same way.

Nurses and other healthcare professionals are expected to remain objective in their written reports - and can be pulled on it if they're not - so I believe doctors should be subject to the same expectations. It's a shame that medicine/surgery are still following these out of date patriarchal practises.

I had similar once, describing me as "this very pleasant patient". I felt chuffed. Not sure why it would irritate you so much.

I find it totally inappropriate and pretty arrogant, not to mention judgemental.

When people go to the doctor's they might be feeling very unwell, be in a lot of pain, have experienced trauma, be stressed out or a million other things.

I find it disgusting that the doctors think they have the right to judge someone's personality from the appointment and then comment in such a way in the letter.

I haven't come across it in other countries.

I mentioned it to a friend whose husband is a consultant, and she said to let the doctors have a bit of fun!

I do believe it's a code to describe the patients and by omitting whichever adjective they'd normally use ('delightful' , 'pleasant' , 'charming' etc) they are letting the recipient of the letter know that they didn't like the patient or that there was some issue of some sort.

There is so much wrong with the NHS I don't know where to start, but having the medical reports kept to the facts and stopping sending underhand bitchy messages about patients would be one good thing.

I have also been labelled 'pleasant' etc and thought half of the letter at least was a load of waffle that would have saved time to miss out.

Also, why do they post appointment dates and follow up letters out using paper and envelopes? This is 2020 for goodness sake and I thought they had a funding crisis?

@rosiethehen

I don't like it when they do this. It indicates that the clinician is being judgemental rather than remaining objective. It's also rather patronising. Someone like me - autistic - will often not come across particularly well, even though I'm a reasonable and pleasant enough person. I wouldn't like to think that it would influence my treatment, but it probably would in reality. I'd be upset to think that a doctor was passing judgment on me - they have in the past - and passed that judgment on to another clinician in the way they refer to me in a letter. In reality, nobody knows anything about my nature as I instinctively hide what I am. I expect people with trauma and mental health issues feel much the same way.

Nurses and other healthcare professionals are expected to remain objective in their written reports - and can be pulled on it if they're not - so I believe doctors should be subject to the same expectations. It's a shame that medicine/surgery are still following these out of date patriarchal practises.

I completely agree with you, rosiethehen.

You have expressed perfectly what I had wanted to say.

It's actually a very nasty tradition and I find it shocking it's still allowed.

My consultants letters ate always on a similar vein as are DH's. "I met this charming gentleman in cli ic today accompanied by his wife ' of it was a great pleasure to meet the lovely gentleman in clinic today there is absolutely nothing steangexabout the letter.

@GlamGiraffe

My consultants letters ate always on a similar vein as are DH's. "I met this charming gentleman in cli ic today accompanied by his wife ' of it was a great pleasure to meet the lovely gentleman in clinic today there is absolutely nothing steangexabout the letter.

'charming' 'lovely'

You clearly passed the doctor's "polite and respectful to me" test.

it's not appropriate in my opinion for a doctor to write that sort of thing.

Why not just keep to the point, briefly summarising the facts?

I really dislike the letters in general. What a waste of time and paper. just record the medically necessary info.

That is literally what consultants write. I'm a nurse. They're all like that.

Yes - but why? No other profession does

If I did this in my profession, I would
Be taken to one side about its inappropriateness and doubtless fires if it continued

It's a shame that medicine/surgery are still following these out of date patriarchal practises

It’s hardly patriarchal when women doctors use such descriptions about male patients. It’s not going to stop so it might be sensible to look for something a bit less trivial to get upset about.

Women are complicit in most Patriarchal societies AlsoHuman. Possibly the women Drs are mirroring the inappropriate behaviour of the male Drs.

It's subjective and in an organisation that supposedly upholds equality and diversity and spends gazillions on justifying his good it's Equality and diversity policies are, it needs to cease. Others make their own interpretations - that removes a level playing field.

You’re ignoring the point I made about such descriptions being applied to all patients irrespective of their sex. It’s hardly patriarchal when it’s universal.

This kind of thing is falling for classic distraction techniques. “Look over here at this trivial thing” while far more important concerns go unnoticed. When the NHS is clinically and ethically perfect, perhaps we can give time and attention to this kind of issue. Unfortunately that point is a long way off.

I'm absolutely taking that point on board. The NHS operates differently from all other sectors and organisations/institutions. When it actually starts acknowledging patients are equal stakeholders and behaves to them accordingly rather than assuming they should be grateful for a free service then the issues of poor clinical competencies and poor communication and the culture of excusing them will be much easier to deal with.

And I don't think it's acceptable to be rude to HCPs and I do think patients who are rude or violent should be ejected. I always challenge but I am never rude.

It’s hardly patriarchal when women doctors use such descriptions about male patients.

I feel sure that if you actually looked into it, it’s far more prevalent with male drs, female patients than the other way around.

It’s not just that though, it’s a throwback to a very hierarchical relationship whereby patients were encouraged to be as docile and accommodating as possible to the big important doctor and ‘rewarded’ with these kinds of comments.

It’s old fashioned, unprofessional and they should be encouraged to get with the times and drop it.

They are being nice. It's a polite, kind friendly thing to do. They do it to open a letter in a more personal manner. Honestly some people are a bit too snowflaky