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.

My husband went to consultant for a second time with a 2 year gap.

The first time he was happy, situation resolved via a day procedure.

It returned so he went back to the consultant.
He was rushing, was suggesting medication, completely different diagnosis for something else entirely, didn't listen to my husbands reply that it was simply reoccurring condition.

He clearly hadn't read his short file.

My husband was very calmly seriously unimpressed and made it clear that he was impressed with his obvious lack of preparedness for the £300 consultation.

Husband quizzed him and on every suggestion he made.

On finishing the consultation he asked my husband what he did....highly techincal field, and wrote on his letter that he was "an extremely well informed patient" AKA a complete PITA know it all🤣

FruityFriday. I'd rather not be referred to by my perceived compliance/geniality etc at all. Could a letter start
"You referred Ecruel to me on 1May and I saw her in my clinic today. She presented with X,y and z and described herself as feeling worried/optimistic/frightened/confused/exhausted about the symptoms she is experiencing. We discussed x,y and z and I have referred her to x-ray etc etc.

I type for Doctors and generally I’d say it just means that you didn’t cause any hassle and were fine to deal with but wouldn’t read much into it. Sometimes I think doctors just say things as they dictate as habit. However if the consultation was “challenging” that generally means you were difficult and not accepting of them

I get 'pleasant' when I'v just agreed with everything they've said and 'anxious' if I'v been more forceful. I also get 'patient x was looking well today' which I think is codeword for she doesn't look very ill. I think it's rude and would rather they didn't make reference to my appearance or manner.

@JackieTheFart

It just means you weren’t an arsehole in your appointment. So the next doc knows you probably won’t be belligerent.

It means you’re pretty sensible and won’t be a PITA.

Ah! That explains it. I recently had an ENT appointment, and my copy of the letter starts "It was a pleasure to see Mrs Schaden in clinic today".

Well, obviously I know I'm an absolute joy and bring sunshine to every life I touch etc, but I was a little surprised that he had enjoyed the consultation so much,. Now I know why.

I've never had a description applied by a doctor (beyond 'xx-year-old woman/lady') and am always somewhat envious on these threads!

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!

Many of the patients I treat, because of the branch of psychiatry I m in, are often very very far from "pleasant" in their presentation when I assess them (and that generally says nothing whatsoever about their underlying personality, it is a product of illness and circunstances). I do of course make a judgement but it is a clinical not a personal/moral one.

What's an acceptable code word for resting bitch face?

"Murderous"?

A consultant letter described my toddler son as “extremely well” after he’d run around yelling excitedly for the whole appointment. I took it as code for “a bit of a handful” 😂

@TheKeatingFive

Mental state assessment does not assess personality, it asseses the current mental condition of the patient

I suspect this is a different thing to referring to a patient as ‘pleasant’ or whatever in a referral letter.

@TheKeatingFive exactly, I was just pointing out that in my field pleasant means something different, and very specific.

I used to be a senior LA officer with responsibility for SEND for a major city. Reports written by Educational Psychologists came across my desk every day and each one of them described the child as "A delightful little boy/girl..."

I had a long discussion with the Chief EP in which I asked her to consider instructing the staff not to do it, because it was meaningless and not - in my view - remotely relevant to the report. This was particularly so when describing children with quite severe behavioural difficulties who - frankly - weren't that "delightful" in class...

In what context is it appropriate for medical notes to give anything other than medical info? I’m just surprised - I’ve been very lucky and have had very few medical interactions other than with the GP and midwife so I’m not sure where this comes up!

OH always gets delightful or wonderful on her referrals

I've never needed referral so I am yet to find out what I get

so I’m not sure where this comes up!

Referrals

@Paspourmoi I actually agree, outside of mental health this is unlikely to be appropriate.

Things like casually dressed and clean (or not clean etc) can of course also have specific clinical relevence in certain circumstances...

Many years ago I had to weed through old medical records for archiving/ destruction. They needed to be thoroughly looked at because cetain conditions need the notes retaining for longer and they weren't always in chronological order.

Most descriptions were of pleasant characteristics. Some drop in practical hints about approach so an HCP would enable more depth of technical discussion, so some occupations are mentioned (or may be clinically relevant).
There was one that stuck with me as the exchange of letters gradually went from terse to outright frustred rant. The patient had a condition heavily aggravated by lifestyle, refused to make changes and constantly demanded magic cures. Increasing amounts of unfavourable adjectives were used. There are many unpleasant, beligerent, and demanding people out there (and I don't mean frustrated requests for reasonable action) and it is fair for HCPs to be warned of particularly difficult people.

My most recent interractions have been around DS and his SENs. I am reasonably knowledgable about it, but pleasant too, not in an I know best way. The original document I submitted to the GP as part of my initial concerns indicated that I had a decent idea of what we were looking at (without presuming at self diagnosing)

A relative recently received a letter from a consultant beginning "Thank you for referring this obese man to me" that was upsetting- that his weight was a defining feature. He's so much more than this!

My consultant described me as "delightful"! What do I read into that? We did have a chat about Fairfax and Favour Boots? ..........................

@Nam3chang3r1 that is a very clumsy wording,and not well-thought-out by the doctor, but if the obesity was the reason for or highly relevent to the referral then the doctor was probably viewing it as just another medical condition, the same as "thank you for referring this diabetic man". It may not imply judgement at all but just poor social communication skills.

I often think about the conversations i have in clinics after the event. I often get asked what i do for a living, which i took as a rather predictable small talk topic but now realise its to work out my level of education. I dont have an easy to pigeonhole career (i went to art school!) so tend to just say housewife but then get questions about what i did before, i end up feeling a bit judged. I usually manage to drop in that my parents are doctors though, and i tend to use correct medical terminology, to avoid being fobbed off without full information.
I was at the skin clinic this week having a suspect lump removed and the staff nurse said i didnt look my age when he asked for my date of birth (combination of long lockdown hair, mask and casual clothing fooled him i think), it would be nice if i got a letter describing me as youthful but i dont think nurses do that kind of write up.

I have dug out my recent letters and I'm a bit gutted to find that my Gynaecologist just launched straight into a breakdown of my symptoms & his findings after my procedure and my General Surgeon just described me as "a previously healthy 38 year old woman"

Disappointing to say the least I thought I could, at least, have swung a "delightful" or a "pleasant"

My boisterous toddler was always referred to as a 'charming young man' on the orthopaedic write ups, which did make me smile at a difficult time.

"This gentleman is mildly demented", said of my lovely Dad, during the early stages of Alzheimers