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.

Lifetime medical secretary here.
I am not sure why comparison is being made with legal correspondence here as it is a completely different profession. The descriptors are helpful to give a pointer to the medical person reading them how the patient may behave. Letters about me as a patient usually say 'This nice medical secretary", which translates as "she will have a fair expectation of what needs doing to sort her medical problem out so be prepared to be put on the spot". Another reason why these descriptors are used is to help the doctor remember vaguely who you are. Many times over the years, I have handed a doctor the patient's notes after receiving a query about the case, seen them skim through their past letters and then they say, "Ah, yes I remember this lady".

I now work in private practice and the latest best practice guidelines are that you must write the clinic letter TO the patient and copy it to GP etc. I really hate this, writing to the patient and saying "You came to see me today.... You told me that...." I cannot see why this is (presumably legally) more acceptable than previous method.

I wasn't pleased to be called 'very anxious' on a referral letter. I could not accept that my considerable pain had no explanation, despite various tests not finding the cause.

Some doctors were obviously trying to help, but others were patronising and dismissive (both male and female in both categories).

Several difficult years later, I was proved right and finally diagnosed with endometriosis.

As it happens I have also experienced an anxiety disorder. This was something separate and I don't believe 'anxious' is particularly relevant or appropriate to describe a person seeking help for an unrelated condition. It just seems to brand you as someone who shouldn't be taken seriously.

@MrsSugar

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

Probably because the patient had previously suffered a dishonest/incompetent doctor/consultant.

My OH isn't afraid to challenge his consultant, and yes, he's one of those who goes in with a pen and paper to make notes of blood test results, etc. He's perfectly polite, but wants to know the details about his long term health condition. It's his life after all.

This comes about by two cases of incompetence with FIL about 10-15 years ago where they nearly killed FIL first time, and finished the job the second time. On both occasions, it was just one foul up after another.

I suspect the "pleasant" description is for the doormats who believe the NHS propaganda that all doctors are Gods and that the patient is lucky to be treated by the "best" health service in the World.

@CeeceeBloomingdale

Agree it's just code for not a pain in the arse. In the paper notes day you would occasionally see gems such as TAPS (thick as pig shit)

And the dreadful NFN (normal for Norfolk) or UFK (ugly fat kid)

When I first started under the care of my consultant I was 'a pleasant young lady' I'm now just a 'pleasant lady'

Not in a letter but whenever I met with consultants during my pregnancy, they almost always made a remark about me being 'well informed'. I like to understand the background of why a course of action/medication/monitoring is being suggested and tend to read up on it so I took that to mean pain in the arse/know it all! I am always polite and pleasant about it though so hopefully not!

When I was at medical school (a very very long time ago) there was "FLK" (funny looking kid) and especially "supratentorial" (basically hypochondria/somatisation, but said in this stupid way so the patient would not understand). These would be horrifying today, thank goodness things have changed! (I hasten to add I have never used those terms).

I had a copy of a doctor's report, that said something like
"Mrs. G presented at the interview, casually dressed."

My clothing was completely irrelevant, & it was a very expensive trouser suit!

I find this so offensive even though I'm usually 'pleasant'. Are we not entitled to a referral however bad mannered we might be?

@user1497207191 The propaganda of doctors being "gods" is not exclusive to the NHS (and in fact, thank goodness, is not really the case in the NHS any more, outside of a few specialities perhaps), it is far more the case in lots of other countries, especially developing countries, still to this day.

@aramox you still get the referral though...

So if 'pleasant' is code for 'not a PITA' what does it say about everyone else who doesn't get 'pleasant'?

Is a patient an unpleasant PITA, just because they ask questions, are difficult to diagnose, have atypical or complex symptoms, or don't want to be patronised or fobbed off?

@Waitwhat23

Not in a letter but whenever I met with consultants during my pregnancy, they almost always made a remark about me being 'well informed'. I like to understand the background of why a course of action/medication/monitoring is being suggested and tend to read up on it so I took that to mean pain in the arse/know it all! I am always polite and pleasant about it though so hopefully not!

It's sad that doctors seem to think that a well informed patient is a pain in the arse. I really hope that's not the widespread view.

My OH has cancer, treatable, but not curable, and has life expectancy of anywhere up to 10-15 years. He needs chemo every few years to keep it under control.

He is 100% all over his condition. He is very well informed as to the treatment options from medical sources (not generic "noddy" internet websites nor social media!). He has taught himself the science behind his condition (bone marrow blood cell cancer).

I'm sure his haematologist isn't impressed at all his questions and, yes, challenging some aspects of the treatment, but it's my OH's life at stake. He's perfectly pleasant when talking to his consultant, never "argumentative" or shouty etc., but he is assertive and if something doesn't sound right to him, he does challenge it, sometimes the consultant changes some aspect of the treatment accordingly, sometimes she persuades OH that her opinion is right and OH accepts that.

If OH hadn't made himself so informed about his cancer and hadn't challenged, I'm not sure he'd be as well as he currently is.

You really shouldn't just lie down and take whatever your doctor/consultant tells you as gospel. They're human, they make mistakes, and they don't know how you feel normally and how you fell when unwell, on medication, etc. Doing your own research and challenging them is healthy as long as you're polite and respectful and not talking a load of crap you read on Facebook!

My job involves dealing with medical reports, and have often wondered about this.

I find it particularly entertaining when the client is described as 'delightful' or 'pleasant' then I look at our system and we have measures in place to protect our staff from them due to previous violent outbursts.

Absolutely agree that you shoud be as well informed as you possibly can and ask whatever questions that leads you to, and (assertively if necessary) insist on answers. I work part of the time in the field of medical negligence, and some of the obstetrics cases I have dealt with in particular have been heartbreaking. Usually where a woman has assumed that the medical staff must be doing the right thing and failed to speak out even though she was uneasy etc, because she did not feel able to question.

DH was once described as a "heavyset gentleman" in a doctors letter.

To be fair, he's not fat but an ex rugby player so on the larger side.

I almost died laughing. He did not find it as amusing....!

I was described as a 52-year-old law firm practice manager, which I took to mean 'don't mess her about, she has contacts...' (no mention of pleasant or delightful however).

And I was delighted recently when my GP told me I had the vagina of a 30-year-old - she was surprised when I laughed, but I'm thinking of adding it to my cv.

I think I had “lovely” the other day!

As a patient I don't think I have ever had pleasant or delightful. They usually put "this xx-year old psychiatrist" which invites the reader to draw their own conclusion (among other medical specialities, not always a positive one...)

I was described as 'stoical'. I think because I didn't cry.

@YukoandHiro

They don't. I've previously had "very distressed" and "clearly anxious". Basically when I was firm about needing some answers.

I've also had "has attended clinic multiple times in recent weeks despite being rarely seen in previous years".... yes, because I'm in pain 🤷🏻‍♀️

As I think someone else said I would put this in a letter because I want the person I am writing to know that you don’t turn up willy nilly so this is actually serious and needs sorting - it’s not an attack

@DaisyBD

I was described as a 52-year-old law firm practice manager, which I took to mean 'don't mess her about, she has contacts...' (no mention of pleasant or delightful however).

And I was delighted recently when my GP told me I had the vagina of a 30-year-old - she was surprised when I laughed, but I'm thinking of adding it to my cv.

I apparently have an 'unremarkable' cervix.

@DaisyBD

I was described as a 52-year-old law firm practice manager, which I took to mean 'don't mess her about, she has contacts...' (no mention of pleasant or delightful however).

And I was delighted recently when my GP told me I had the vagina of a 30-year-old - she was surprised when I laughed, but I'm thinking of adding it to my cv.

I envy you. I was sent off with a senile vagina while still in my 30s.

Yes the comment about coming in a lot after not having done that in the past is actually helpful, it flags up that something is unusual, rather than part of a chronic pattern.

@luccyloo

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.

It’s a Letter about your health - it’s in the job description of a doctor to state if you look well or unwell surely.....it’s also part of the job to take into account your mental health and satisfaction with the answers given and record that in your notes,

Maybe it could be better written “ms bloggs asked lots of questions and I could answer a few but she still has anxieties about x y and z” the record does need to show that you weren’t fully satisfied with the answers. How would you write it?

“Well informed” can also be helpful as it lets your doctor start nearer the right level- it means for example I should use oesophagus not food pipe when talking to you (some people would feel patronised by the simpler term but others won’t understand the medical one) or that you have already researched the symptoms and have some ideas what condition it might be and I should explore that rather than slowly working my way up to discuss a serious diagnosis in so one who has no idea.