To wonder why doctors always refer to a patient as pleasant

[Beatinghearts]

I find it strange these nothing particularly pleasant about me. I’m polite but not overly so.

Consultant once described 15mo DD:

'...was certainly very lively and appeared well'

During the appointment she had to be stripped so that she could be examined properly. Somehow she managed to wriggle free and bolted naked out the door into a busy waiting room. I left it to the consultant to try and catch her

DH was described as "humorous" as well as very pleasant. The same letter mentioned his "well informed and supportive wife". Not sure if that means the consultant thought I was a know it all and very protective - he did have a terminal illness, it was important that I knew how to care for him. And I got the info from the Macmillan nurse rather than the Internet.

I was once described as "colourful" and "charming" - presumably because I had blue hair? I'm not an arsehole.

@Cbtb fine if it's relevant but where I'm being seen for a condition that would not affect my physical appearance/have any side effects that would make me appear unwell I think it's odd to mention it. Perhaps that's me being overly defensive though having had several male Drs overstep boundaries.

I also think anxiety shouldn't be used unless the patient has actually indicated that they are anxious or have been diagnosed with anxiety. For some people seeing themselves labelled as anxious will put them off seeking medical help in the future.

@MitheringSunday

They don't do that where I live. It's just 'I saw Patient ABC on 123 for XYZ' etc. Much prefer it that way. A doctor's judgement on my personality has no place in a medical report, which, after all, is supposed to be a record of facts. I think it emphasises the power differential, as it being there implies a right to judge the patient's character. I get it's convention, etc etc, but the sooner it dies out the better.

I don't mind 'appeared very distressed' or whatever, as tha records something that was observed and may be relevant (and is marked as a subjective observation).

I couldn't agree more @MitheringSunday.

Working in the IAPT system I have frequently written to patients GP's.These letters of course form part of their medical records.
I would simply state: 'I saw X as part of an assessment / as part of a course of therapy for Y'. Given that IAPT is part of the MH system I would mention if a patient showed initial or ongoing clinically significant symptoms of Depression or GAD but only in those circs.

Subjective / coded 'character references' are just that - too subjective and hellish difficult to get struck out if the patient disagrees or feels upset / affected by them.

@Landofthefree

I’m always chatty, smiley and polite to all medical staff, because I know most of them want to do their very best for their patients. I have many regular medical appointments and it’s awful that so many people are rude, unpleasant and abusive towards medical professionals. I’m often shocked at how people speak to doctors, nurses and receptionists. My occupational therapist told me I’m her favourite patient because I’m cheerful!

You catch more flies with honey than vinegar!

I agree , its probably better to be happy, chatty, smiley etc, but if you are in pain, worried about what's wrong with you, worried about your job because you've put it at risk just for going to a hospital appt, worried about a zillion other things then some people are going to be rude or worse.

I had a dr ordered check up once ( I think because I hit a set age, not certain) and they found a thing wrong with me. I had to go through various different tests. think blood test then camera, then scan over several weeks and as each test was negative my worry levels went up because the final diagnosis was cancer. By the time I got to the last test I was terrified and quite abrupt. But honestly I'm normally ok, maybe not chirpy but a reasonable person. So I can see that in certain circumstances medical staff get some shit. Not their fault obviously but its understandable.

@Minthambug

Apologies that was meant to quote someone who was asking why it would be important.

Lots of these observations can be as important as blood pressure etc. Handedness impacts function, so its important to know if you are doing anything related to upper limbs including neurology type stuff

Comments about speaking English at home, might be to clue people in that the language is their second and they might need some communication checking, equally its probably important developmentally as kids who speak second languages can appear "behind" in one when they are not

The comments about speaking English at home certainly made sense on their notes from the child health clinic when they're writing about their development, less so on a tonsillectomy referral!

I wonder how many men are called 'anxious' in their referral letter.

DS (9) recently had a dermatologist referral. The consultant's letter to our GP afterwards described him as "a pleasant 9 year old boy with a pet goldfish."

The consultant did make small talk with DS and asked if he had any pets, but I had no idea that his mention of his pet goldfish would make it into his notes. The letter made it sound like the goldfish came along to the appointment!

Why would people be upset by an observation that they were anxious? Anxiety is a totally normal human emotion.

Pets could be relevent to a dermatological referral...

I normal get pleasant young lady, thank you very much for referring X etc etc

Then once I had an appointment where I felt tearful after being given a chronic/incurable diagnosis. I wasn’t wailing or blubbering, just nodding my head with a tear rolling down. The consultant wrote “quite tearful” in the letter. I don’t really see why it had to be included in the letter at all, but the “quite” in particular makes me seem much more dramatic than I actually was

Our doctor called my son handsome in a report. A handsome young man who wears glasses. It had nothing to do with his vision atall.

Yes I did wonder about that @theDudesmummy, but assumed this would only be relevant if the pets were cats/dogs or other furry pets!

I got “lovely lady” which I took to mean that I am a truly excellent human and his consultation with me was the highlight of his week. I now see it simply means I’m not a twat

There are in fact some skin diseases you can get from fish, I believe (but I don't know anything more, dermatology is not my strong point!).

I was describes as a "lovely young lady" in my late 40s?
I assumed that the twat of a consultant was being sarcastic.

My favourite on one of ds was "mum is extremely sensible and ....."

This was a time when ds had all sorts of sights and symptoms of stuff then it would disappear and something else would crop up. I was worried they thought I was imagining it or making it up until I read this which basically said I deal with ds well and wouldn't use the medication prescribed unless true oh needed.

Eventually ds was diagnosed with a very rare genetic condition and now he's a pleasant young man who takes his condition in his stride

I've read a few of these letters during a previous job and the one that made me laugh mentioned a 'hard working postman ' I mean did the consultant follow the guy doing his round..??

I was indeed delighted to be described as delightful, was this in fact code for something else?

I always get asked what I do for work during referral appointments but that’s never documented in the letters! Guess I’m unremarkable

Just be glad you haven’t been referred as a troubled patient or someone that doesn’t co operate . I’ve had both on my forms.

@Barbitchurate

so good clinicians will never put anything judgemental or overly subjective in writing.

I had a MBP diagnosis in a letter, by someone who wasn't qualified to diagnose such an illness - my GP received the copy and called me to say not to open it but it was too late.

The illness that the consultant was claiming was fabricated nearly killed me (cardiac arrest and flat line) just two weeks later. So unfortunately consultants do get away with writing whatever the hell they want on letters.

Well actually said consultant is not really getting away with it now - but it should never have been written, or thought, without thorough investigations.

How are you now? Hope you've managed to get some decent care and recovery

Docs can be weird though. Or nurses. Can't remember. Two have made comments about my interior while doing a smear

@NiceGerbil - During a transvaginal ultrasound, a very grumpy sonographer told me I had an "ancient and arthritic womb" - it is a good job that I am "pleasant" (or so my consultant's letter said) and not easily offended.

I havent come across this IRL but this thread comes up a lot so it must be a thing. Is the OP not coming back to get the answer to her question?

Is it just in England you get sent copies of these letters? I live in Wales and have never received them, despite seeing a few consultants in various fields.