to wonder why consultants have a reputation of being so rude???

[staydazzling]

Been in hospital a few days, nurses, midwifes, auxiliary, care staff all very keen to do their best in hard circumstances always trying to help, largely on time etc, I sadly couldn't say the same for the consultants /surgeons sadly not just in terms of taking literally hours to turn but also how i saw them speak to said, nurses, midwifes, care staff etc and patients.
I jokingly mentioned this to a relative who works cleaning and sterlising equipment, who said yes its well known sadly, your lucky if any move or say thank you for returned equipment, i just wondered why is this a thing, AIBU to wonder where did that culture of behaviour come from?

Well as I said in my first post consultant is a grade of Dr

So some anaesthetists are consultants and some are not (because they are staff grades or trainees)

That's why the whole premise of this OP is just weird. It suggests Drs are OK until the day they make consultant and then become arseholes. Plus it lumps a tonne of different specialties together as being all the same.
If you didn't realise anaesthetists can be consultants what about pathologists? Radiologists?

There is no logical explanation for OPs assertion

What is more likely is
Some consultants are lovely and some are horrid
You expect consultants to be superior and intimidating so you find them so (I know this because people started to treat ME differently when I became a consultant or are surprised to find I am one)
You believe outdated Lancelot Spratt stereotypes from the 1950s
You recall instances that fit with this popular narrative and not those that don't.
You have expectations that don't fit with the consultants job role eg OP does not appear to get why the consultant might be less available on the ward than the HCA

FWIW my mum still doesn’t realise I’m a doctor...

(I’m a dual qualified anaesthetist / intensivist)

What I dread when I see a new consultant or GP is when they assume I'm totally ignorant of medicine and my health condition and treat me like at year old wasting appointment time telling me things I already know.

I get that with any new GP until they get to know me and it becomes more a case of me 'what can I do for you today' and we can go I to discussing the details of my circumstances. It's more difficult with a consultant who I only see once.

Some are great though and will start the consultation by listening, other will look at their notes, and either do the examination without saying a word or will just indeed just say things I know already which feels a complete waste of my time.

I work with them, most of them are okay, some are really nice, some are horrible, they’re very different with their own patients though, very pleasant, polite, compassionate, can’t do enough for them, with (some) staff they see as not worthy of their respect I.e. nurses, technicians, radiographers etc., they’re rude, abrupt, have no patience, hypercritical, unprofessional at times, patronising etc.

I don’t think it’s stress since they can turn it off and on, I think it’s narcissism tbh. If they don’t care whether you like them as there’s nothing in it for them either way, they don’t treat you with respect. Their “niceness” is something they perform for certain people when it benefits them, like their own patients and other consultants.

I have met some lovely consultants and some absolute stinkers. On the whole in percentage terms I have met far more rude nurses than Drs or consultants, midwives being the very worst. Paradoxically, I'd say that registrars have on the whole been ruder than consultants. I shall never forget three in particular:

The first in a cli ic when ds was a baby and seemed to have intractable asthma "you all turn up late and now you are all here at once". I wasn't late but did walk out and have him referred privately to The Brompton. Best thing I ever did so actually she did me a favour.

The second in hospital with 7 month old dd who had bronchiolitis who stood over me demanding to know how much milk she was taking and would not accept that I couldn't possibly know how many ounces she was drinking as breaststroke didn't work like that. I saw her again in clinic weeks later and she remembered me. At that time I hadn't been without sleep for three days and was able to have a sensible conversation about the fact that breasts weren't calibrated.

The registrar when I was being induced with dd who came to examine me and put down a tray with instruments and when I said, if you are going to mechanically break my waters as well as examine me I wish to have a conversation about it first who said "if you think you know more about this than me I won't touch you"and walked out. To be fair the midwife was very apologetic and suggested the shifts would change soon and the next one was nicer. As it was my waters ruptured naturally a few hours later.

One consultant really got my goat though. DD had a gynae problem and I had her referred privately to supposedly the best gynae consultant in the area. The hospital website said clinic hours were 4pm to 7pm and I asked for an appointment as late as possible because I worked full time (that was one reason we had private cover). The hospital rang back the next day to say that Miss x didn't like having her time wasted so if patients didn't book in before me they would move dd's appointment forward. Such a last minute change was not possible for a professional parent and they just said it was the consultant's rule not theirs. Therefore I rang her secretary on the number quoted on the BUPA website and was bollocking for calling her as she was an NHS resource and didn't have time to waste on Miss x's private patients. I cancelled and found another consultant at a neighbouring private hospital - an absolutely delightful woman. What took the biscuit was that just post surgery the other hospital phoned me to say Miss x wanted to know why I we hadn't attended and why we had wasted her time. I had cancelled the appointment. I did write a letter of complaint and actually got a very nice and apologetic reply saying she would review her practices. However of concern was the fact that she was also a member of the local hospital's senior leadership team.

Overall I think there is an imbalance in the way the NHS is set up and it doesn't necessarily always benefit standards of customer care. It is free at the point of delivery and there is therefore no impetus for NHS staff to always be polite because at the end of the day they are not reliant on the patient paying the bill. I work in the public sector but know if I were as rude as hip's sometimes are my job would be at risk. DH spent the majority of his career as a commercial lawyer and I know that had he been as rude as many HCPs are his client would not have settled their bill.

And finally as so many Drs are on this thread, please use patients' names. If you introduce yourself as Dr or Mr or Miss please do not expect me to afford you the courtesy of a title when invariably you and your staff use my first name and do so without asking. Of course my first name may be used but only if you invite me to use yours. To do otherwise is an act of passive aggression and it is embedded further when the staff around you call you Dr or Miss or Mrs and in the same breath use my first name. No patient is subordinate to any Dr and all stakeholders in care should be afforded equality. It is a situation that underpins poor service and considering how much the NHS spends on equality & diversity and the trees that are felled in its name to facilitate report after report leaves me agog that a simple matter of basic courtesy continues to prevail.

We have a home in France and it is a much better system. In all our interactions there there has never been the air that one must be grateful for a free service - because it isn't. Money changes hands but all to often those within the NHS think it is only free at the point of delivery.

Having said all that I have met some excellent and wonderful drs and equally make a point of ensuring a thank you letter is sent when care has been very good and services have been delivered well.

Penultimate para: all too often those within the NHS think they are providing a free service. It is only free at the point of delivery

There are 12 consultant psychiatrists at my place of work and 9 of them do indeed think they are Very Special and Important People. That said, I would trust each and every one of them with the care of my children, my husband, myself if I needed it, and can forgive a little arrogance and impoliteness because when it matters they will work their Very Special and Important behinds off and I have seen the pain behind the façade of arrogance when a tragedy happens. You need a certain level of confidence to be a consultant.

I find the consultants at children’s A and E the best in the world.

Whilst they are not god, they are certainly interfering with the course of nature. This goes for nurses, midwives etc, too and this is bound to mess with your head. The consequences of decisions can be immense. May explain why midwives are also mentioned as being very rude.

I introduce myself as “Firstname Surname” and address patients as “Title Surname”.

However, my trust also removed surnames from the ID badges of all staff working in A&E a while back because of a number of security incidents with staff being threatened / stalked / generally harassed at home as well as at work (usually for drugs).

I suspect @parallax80 you must be in a minority. The last time I attended paediatric A&E the very pompous consultant introduced himself as Dr xxxx and asked if I was "mum". Didn't so much consider using even my first name. He also treated the nurses as though they were his secretaries. Ghastly young man and it didn't help a situation involving dd's mh. He even told me I had given him permission to contact SS and in any event it wasn't possible to make a CAMHS referral without doing so. Interesting as SS later confirmed the hospital had made the referral at 4.06pm. I wasn't informed dd was at A&E until 5.48pm. So that particular rude and arrogant consultant was a liar as well. Although the CEO apologised personally that little bit and that particular gentleman's conduct was not satisfactorily dealt with. Whether it was behind the scenes I shall never know.

I’m sorry you have had what sounds like a series of bad experiences. There’s no excuse for being rude to people, and while none of us get anything perfect all the time, an apology is better than nothing.

I don’t think I’m in a minority particularly though. I can’t think of any colleagues who introduce themselves as anything other than “Firstname Surname”.

Perhaps it’s an anaesthetic thing? Or that particular departments develop an ethos of what is acceptable behaviour?

Of course I don’t see eye to eye on everything with my colleagues but as a group, we are polite and pleasant to our patients and other staff. And I would expect to have my ass kicked or at least be pulled up on it if someone found out I had behaved poorly towards someone.

What a massive generalisation!! All just human at the end of the day. I'm an AHP and also have a chronic illness. So plenty of interaction with all medical staff.

I introduce myself as Dr surname. I do not encourage patients to use my first name.

However I also refer to them as Mr/ Mrs/ Ms surname unless they request I use their first name (a fair few do these days)

It is a professional boundary issue. I am not their friend. It helps people to feel safer when being touched in an intimate fashion if the Dr is not overly pally I think. I do not engage my patients in conversation if we meet outside work for similar reasons and I do not welcome direct phone or email contact. Drs over the years have got in all kinds of trouble failing to keep relationships on a professional footing.

I possibly am quite an old fashioned person though. I refer to my children's teachers as Mr/Mrs/Ms surname and to my own GP as Dr X which apparently most people don't these days.

I find some formality reassuring.

If they don’t care whether you like them as there’s nothing in it for them either way, they don’t treat you with respect

Exsctly. One of our consultants is incredibly nice to his patients. I'm in the room, often enough. They beam at him. If one of his patients were on this thread right now, they'd be saying "Well Mr X is lovely, I can attest to that personally".

This would be the same guy that I've done countless procedures with, who never ever ever says my name or says hello to me. He knows my name, he just doesn't deign to say it. Who grunts when I have to ask him a question. Who never makes eye contact. Who ignores the existence of all nursing staff and who sighs whenever we have the audacity to ask him a question. Obviously we avoid asking him anything or really having to have any interaction at all, so I guess it's working for him.

So yeah, they pick and choose their manner all right.

And you know what? We're all stressed! I'm on my knees with staffing shortages and Covid! Stress is NEVER an excuse!

I possibly am quite an old fashioned person though. I refer to my children's teachers as Mr/Mrs/Ms surname and to my own GP as Dr X which apparently most people don't these days.

I do this too.

@DougRossIsTheBoss quite right too. I have no wish to have anything other than a professional relationship with an HCP. I hope you agree it is very passive aggressive when Drs call the patient their first name whilst introducing themselves as Dr or Mr Smith. Usually I extend a hand and say I'm very pleased to meet you Mr Smith, I am Mrs Hellebores. Then they splutter and say "oh you can call me Paul". Just why?

Something becoming more common is the habit of younger Drs introducing themselves as Dr Mary or Dr John. One young lady at my surgery actually said "you can call me Dr Jane, my surname's really long and foreign and it's easier because none of you (yes she said you) patients can pronounce it properly. So in one interaction intimated I was both her subordinate (no attempt to call me Mrs Cressida ) and too stupid to pronounce her name. I have one of those quaint English names that isn't pronounced as it's written - along the lines of Cholomondeley - and in the 30 years I have been married have encountered no difficulty explaining how it is pronounced and if people get it wrong they get it wrong but never would I say "use something else because my real name will be too hard for you". It would be beyond rude.

I'm a MH nurse. I work regularly with consultants and they're just like anybody else with their individual quirks and styles of communication. I know I could never cope with the amount of pressure that they are under and the weight of that responsibility and accountability would keep me awake at night. I generally get on well with all of them and try not to take it personally if they're rude or less than personable.

We are instructed by trust management to introduce ourselves as “hello, my name is Firstname” (off the back of the “hello my name is..” campaign, started by Kate Granger who was an oncologist and cancer patient).

Whether or not you agree with the campaign is one thing, but that may explain some of the “call me Paul’s”

I do believe Drs should use patients surnames unless invited not to yes. I would agree with you on that.
What they call themselves is their own choice but in my opinion first names are not professional and I encourage my junior Drs not to do this.

I do have some junior Drs who do use Dr Firstname or Dr Shortened name. Usually Sri Lankan ones. I think it's a bit sad but it is usually a response to years of rather racist people making no effort to try to pronounce their name or even mocking or laughing at it.
I don't blame them for abbreviating under those circumstances.

One of my poor Drs his name didn't even fit on the name badge so people always addressed him incorrectly and this issue was not able to be rectified as 'computer says no' there are only so many characters allowed. He had to choose a short version against his will.

I don't have an issue @parallax80 with using a consultant's first name and them using mine (although I prefer Dr and Mrs when I am potentially vulnerable) but I have an issue with a Dr introducing themselves with title surname and assuming they may in that circumstance use my first name. They may not - they may address me as if I am their equal.

Yes, I think we agreed on that above.

We all have these bright yellow dementia friendly name badges now and I am afraid I insisted mine say Dr surname. I really do not like patients using my first name. It just feels all shades of wrong to me.

It's not a power thing though. I'm not unfair about it. I don't want to refer to anyone who is not my friend by their first name or have them use mine. Not mortgage advisers, waiting staff, shop assistants, call centre people. None of them.

Beyond the initial introduction there surely isn't much call for using names when speaking 1:1 anyway. I abhor this constant dropping your name in whilst talking stuff that clearly is in the script at all centres 'well you see Doug' 'now I'll just put you on hold again, Doug'

Just introduce yourself politely at the start and then say what needs to be said.

You make an interesting point there @DougRossIsTheBoss and racism in all its forms is deplorable. What is interesting though is that my maiden name was forrin and I have an unusual first name (Hermione/Cressida genre) and as a child my recollection is that those who remarked on it and/or ridiculed it a bit were usually nurses and I still get comments now "ooh that's an unusual name? Where does that come from?". It has been incredibly tiresome all my life and also it crosses a boundary. It may be why I am sensitive about it and other issues of equality.

Oh I don't mind my first name being used in other environments. My accountant is Tony, my solicitor is Fiona but I suppose they are also now friends.

We always called the children's teachers Mr, Miss or Mrs but it notably became more informal the older they became and the more we paid. DH's former housemaster whom we got to know well sends us a Christmas card still but it's from Ian and Jane. DS however, still calls him Sir if he sees him, as he does because they come to our parties (when we can have them) and so he should.