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What does it mean when a DR or nurse says this??

118 replies

Upsidedownsouffle · 14/08/2022 01:40

I saw a consultant 2 weeks ago at the hospital and could see my notes on the screen and saw the referral letter said ‘Upsidedownsouffle is a pleasant (age)year old lady’

just to clarify I’ve got a great GP and have never had any bother whatsoever. Thankfully I’ve rarely had to go, but anytime I have gone they’ve been really helpful and solved the problem or helped in any way eg referring me. I always say thank you and sorry thousands of times in a single conversation (I’m one of those people!) and I probably come across as really annoying but I have a phobia of coming across as rude or obnoxious to people.

im just purely curious as I’ve never actually seen a referral letter- when it says pleasant, does that mean the GP genuinely thought you were a nice person? Or is it just an automatic thing and it doesn’t mean anything?

when I read it I was like awww that’s nice maybe I’m not the rude horrible person I’m so scared of being, then I realised it’s probably just an automatic thing and doesn’t mean anything 😂

OP posts:
Widily · 14/08/2022 08:32

I manage a team of 12 PAs typing around 800 clinic letters a month

You would not believe some of the outrageous stuff consultants dictate. My team are very good at changing wording or checking with me if they aren’t sure.

The older the consultant the worse it is :

Dear GP,

I won’t thank you for referring this extremely difficult man to me…….

Dear GP,

I had a telephone appointment with Mrs X today, an interesting character to say the least.

Dear GP,

Mr X is a rather overweight man of x years who arrived late for my clinic this morning.

We quality control before they are sent out!

Pleasant lady is completely generic - they all say it

comfortablyfrumpy · 14/08/2022 08:32

cakeorwine · 14/08/2022 08:19

For all Cabin Pressure fans

"I saw this brilliant lady today. She was brilliant"

Arthur, how would you describe your Dad?

"uuu, uuu, he's alright"

"Not brilliant. He must be awful!

Brilliant! 😂

BabyDreamers · 14/08/2022 08:33

My sons referral letters always say crap like.... 'he is an attractive, slim, glasses wearing young man'. I always think it's really weird.

Gardengirl108 · 14/08/2022 08:37

A recent consultant’s letter to his dr described my husband as ‘lovely’. We took it as a compliment. Consultant is right, he IS lovely 🙂

MRex · 14/08/2022 08:42

cakeorwine · 14/08/2022 08:13

Sounds like teacher code

She is a pleasure to teach,
James is always keen to show he knows the answer
Sally is a highly confident individual.

Ah yes, we got this at the nursery celebration.
"Lara, we've loved hearing all your stories."
"James, you've loved telling us everything about tractors."

We all heard the difference loud and clear!

Chouetted · 14/08/2022 08:44

Doubleraspberry · 14/08/2022 08:30

I once got ‘thank you for referring this delightful [job title] with lumpy breasts’.

Better than being a [job title] with delightfully lumpy breasts Grin

OnTheRunWithMannyMontana · 14/08/2022 08:58

If it doesn't say this on any of my referral letters (and there are a fair few) does that mean I haven't realised that I'm a massive PITA? 😂

dottycat123 · 14/08/2022 09:04

This is actually quite old fashioned now and health care professionals are advised not to include personal judgemental comments in letters even if it's a positive comment. I write lots of letters in my HCP role and would never include anything like this.

Minimalme · 14/08/2022 09:14

My eldest dc has a medical condition which has required seeing consultants regularly since he was little.

He always gets "It was a pleasure to meet this delightful, smartly dressed child".

My middle son has a severe LD and has also had lots of consultant appointments. He has never had any nice things said about him and it actually makes me really sad.

However, the teachers at his special school adore him and recognise his sense of humour and beautiful soul.

Thisbastardcomputer · 14/08/2022 09:20

I saw a private consultant after a car accident.

I was described as pleasant and sensible, he asked me about stress regarding the accident. I said work causes me stress, nothing about the accident does, it happened and I dealt with it.

horizontilting · 14/08/2022 09:22

There is research that shows patients classed as "difficult" by doctors have better survival rates.

The "difficult" categorization is attributed to the patient questioning and challenging things.

SpongeBobJudgeyPants · 14/08/2022 09:22

Snap. Just had this. But included, "Right handed pleasant lady" which sort of made me chuckle a bit.

Lalliella · 14/08/2022 09:24

My boss NEVER says please. Rude twat. I wonder what his referral would say.

DM and I have both had lots of referrals and we’ve seen this a lot, and wondered, so thank you for this thread OP, you’re a very pleasant lady 😊

horizontilting · 14/08/2022 09:25

Minimalme · 14/08/2022 09:14

My eldest dc has a medical condition which has required seeing consultants regularly since he was little.

He always gets "It was a pleasure to meet this delightful, smartly dressed child".

My middle son has a severe LD and has also had lots of consultant appointments. He has never had any nice things said about him and it actually makes me really sad.

However, the teachers at his special school adore him and recognise his sense of humour and beautiful soul.

Your son's teachers get to know him far better. I have a son with a severe LD and people who spend a lot of time with him are those that really get to know him too.

TokyoTen · 14/08/2022 09:27

It's standard consultant.speak for a referral letter it means you are not expected to be any trouble or kick-off!

dolphinsarentcommon · 14/08/2022 09:30

I once had ' her breasts are also unremarkable' in a clinical letter.

Fortunately I knew it meant 'nothing noticeably wrong'. My husband has never forgotten it 🙄

Hlglu56 · 14/08/2022 09:40

I work in a hospital. I see this same phrase all the time at the beginning of letters.

iloveeverykindofcat · 14/08/2022 09:43

teacher code
In high school
'Sam has worked hard and made good progress' - I have absolutely no clue which one Sam is, but I assume he's fine.

Luxa · 14/08/2022 09:43

*There is research that shows patients classed as "difficult" by doctors have better survival rates.

The "difficult" categorization is attributed to the patient questioning and challenging things.*

That's fascinating. Difficult we must be, if we don't want to be pigeonholed and patronised.

Deguster · 14/08/2022 09:46

My son’s letter from the pediatrician said “scrotum is unremarkable”.

Poor kid. Takes after his father!

Livpool · 14/08/2022 09:50

Spinfit · 14/08/2022 06:20

I automatically use pleasant unless the patient is not pleasant in which case it is just "Thank you for referring this X year old lady" 😅

Ha!

I got referred to as "extremely pleasant" by my asthma consultant earlier this year - I must have been charm personified 😂😂

zingally · 14/08/2022 09:56

It's just doctor speak for "not awkward, shouty or difficult, no need for security to be on stand-by". Both my mum and I have had that phrasing on referral letters for different things.

AnnaMagnani · 14/08/2022 09:57

It means nothing. Some doctors write this on every clinic letter unless you were smacking them in the face.

It always makes me laugh when I see it on a letter about a patient who is a massive PITA in my service.

I used to write it, but now write it on none. Sorry if you've ever had a clinic letter from me and were disappointed I didn't think you were pleasant or delightful. I probably did, but I stick to writing a clinical assessment now.

Mudblast · 14/08/2022 09:58

We use phrases like this a lot in mental health. What we are often describing is the absence of abnormality, often the reverse of whats documented would be significant if that makes sense?

Often the letter is the only record that exists of your appointment so if someone asks me to justify a decision (sometimes years later) i have to be able to remember specific details.

Well dressed/well kept/well presented= justification why it feels some one isnt self neglecting. Someone who was poorly dressed might be struggling and it be a symptom of relapse, or in need of further support. If people obviously arent washing then thats a big red flag. Things like odor, poor skin etc can also be a symptom of other medical needs including meds side effects

Pleasant/engaging/forth coming etc= usually means that they werent vague about family history and you feel you have an accurate picture. If someone sits and barely engages eg just nods or barely answers then theres more likely hood of cognitive issues, or low mood or simply that they dont understand whats happening, and that you might be missing important parts of the story. They might not be being honest with you (either willfully or due to not being able remember) so you might be less certain of the picture. It shows youve been able to have a full conversation with them about the treatment plan and that they are on board with this, rather than someone who doesnt agree the treatment being offered (for example if youre referred for another dr, they know how to start the appointment eg if youve been referred for physio and your enthusiastic about this or think its a load of bollocks so need more explanation or a different approach when you arrive) or is dubious about it.

Things like normal speech tone, pace etc seem odd to note, but thats a stark difference from someone showing the symptoms of a manic episode where they are talking non stop, speaking too loud and not interuptable, or signs of depression which impacts speech too

It can be the difference from seeing two patients who rate their mood as 3/10 and have come for help with depression. One of whom comes in open and honestly, is well dressed with make up on and is forthcoming, and wants to engage with therapy and suggested it themselves. The other comes in, struggles to make eye contact, looks like they havent showed in week, havent been able to wash, and is mono sylabic and ambivalent about therapy

Obviously they arent the be all and end all and make up doesnt mean someone isnt depressed

Equally they can be describing factors

Weight is an indicator of other issues eg hormones and thyroid. As well impacts prescribing levels and need to monitor side effects of meds or need to look at things like blood pressure

Things like anxious etc indicates someone might need more gentle handing or more explanation rather than a blase attitude at next appt

Summersdreaming · 14/08/2022 10:03

I noticed this when dd was being referred left, right and centre. "Pleasant", "delightful" "it was a pleasure to.." I was always weirdly pleased to get 'good feedback' and not be the PITA mother of the sickly child 😂