Comments my gp left on my health record

[watermelonlipbalm]

Hi all, I'm just wanting an opinion as to whether it was appropriate for a GP to note these comments on my health record.
I've only just really realised that you have access to your medical records via the NHS app so I was having a nosy through them this morning and I was just a bit shocked to see what a GP had wrote.
I had a telephone call with a GP a few weeks ago. I actually obtained the contact details from the practice as to how to put a complaint in about the doctor because she really upset me with her attitude towards me and my worries when we had our telephone appointment. Unfortunately I just haven't gotten around to actually write the email yet, but nevertheless, the conversation did leave me feeling upset.
I won't go into exact detail, but I've been really worried about bleeding between my periods. It was completely unusual for me, it started faintly but ended up being quite heavy and I was passing a few clots aswell. Last year I had some bleeding between my periods, albeit completely different to this. I spoke to the Doctor Who referred me for bloods and a scan immediately. So I don't think it's surprising for me to not expect this to happen again. So when I had a telephone call from her I requested this and she shot me down pretty much straight away. She said that she would want me to bleed for three cycles before they would investigate further. I was quite surprised and just said that I didn't really agree with this and I would like to have bloods and a scan like I did last time. She became very abrupt with me at this point and despite agreeing to refer me she made it abundantly clear she wasn't happy about doing it and even said to me "i'm not gonna sit here on the phone arguing with you when I have other patients to call". The conversation wasn't an argument. It was me expressing my concerns and her not reassuring me enough for me to feel happy leaving the call. Whenever you see Doctors on telly, online, in magazines they're are always telling you that they are happy to help your queries. I did not get the impression from this doctor. And it just really upset me.
Anyway going back to the app this morning I noticed that she noted that the call was "a difficult call". Now I know that that isn't exactly an offensive term, but I don't really see the relevance of putting that on my health record. The call was a difficult call because she was clearly in a bad mood that day and wasn't that interested in my concerns. It's frustrated me even more than what I already was at a worrying time for me. I'm just after opinions really. Is this a relevant thing to put on a health record?
I work with vulnerable customers albeit in the financial industry and not medical. We would never be allowed to make a comment like that on somebody's file. You can only really state facts and not opinion. I mean I suppose is a fact that it was a difficult call, but I don't really see what relevance that has to my health and why it should be documented for other professionals to read. Insinuating that I was the one being difficult and not her which is what the issue actually was.

But this wasn't a negative judgement about anyone.

She just said the call was difficult. OP agrees that it was so why is it a problem to write it down?

She said it was a difficult call. Not that you were difficult. There’s a difference.

My ex was a GP.
Difficult call doesn’t mean you’re difficult.
The situation is. But it was a difficult call and that’s ok. As far as I’m concerned, we have autonomy over our bodies and somewhere between NHS protocols, a really poor service most of the time, and your valid worries lies the best approach. Nothing wrong with you fighting for that best approach. Keep pushing. Her job is to provide you with a service, not lip service.

For me, I don't like it as the implication is that it was the patient making it difficult. I know I wasn't in my situation.

I don't see how 'a difficult call' is inappropriate or judgemental, it just sounds like an accurate description

I can't comment on whether you should or shouldn't be referred for a scan as I'm not familiar with the guidelines

It was a difficult call! Do u want her to lie and not mention it.
You had full investigation last year. Did they find anything or recommend treatment like a mirena?
She gave you the plan she thought appropriate, you demanded bloods and another scan which in her medical option wasnt warranted but she agreed to refer anyway.

Where are you getting me demanding tests?
I asked for tests because that's what I had last year and I was not told why the process had changed.
Asked and demanded are two completely different things.

Thank you, I really appreciate this ♥️

Whenever you see Doctors on telly, online, in magazines they're are always telling you that they are happy to help your queries.

Maybe that's because they mainly spend their time on the telly, writing online or in magazines and only do a couple of sessions a week of actual patient care?
I imagine theoretical patients are a lot easier to deal with.

Besides, it doesn't seem that this doctor was unhappy to see you or help with your query; more that what she felt it appropriate to offer didn't meet your expectations.

I think it was understandable thing for her to write. You disagreed with her and got her to do something she didn't want to. You said it was a difficult call and I don't understand why you don't like the fact that she noted that. It will encourage Doctors who deal with you in future to make sure they explain things to you carefully.

At least she didn't write those codes like GP's were allegedly supposed to write on notes... ''FLKNM'' Funny looking kid, neurotic mother'

..I'd not worry about ''Difficult call'' as it clearly was.

Just for context I work in complaints in the finical industry. I know what is acceptable when it comes to discussions with people. I might not have a medical record but I know from my own experience at work and also just general manners that she was extremely abrupt and disinterested in soemthing that was very worrying for me.

I'm not the only person in the world to ASK not demand investigations and I'm not being made to feel bad for ASKING for this. I'm happy she referred me for tests and that's that. Hopefully everything will come back clear as she seemed to find pleasure in telling me that I'm not urgent and will wait my turn so I haven't had anything yet.

I think a More factual comment about the call would be "I couldn't be arsed with this customer today so spoke to her like a 5 year old" instead of "difficult call".

I think I wouldn’t be too worked up about this. A single incident of bleeding between periods realistically doesn’t warrant a referral. The eisyof it being something serious is small but in a stretched NHS there are people with quite challenging complications who need those appointments.

I was referred to gynaecology and a scan/colposcopy previously for bleeding that lasted 6 weeks. I’ve had bleeding between periods since but if not regular, I wouldn’t go to the GP about it.

I think what she was trying to say is that you were pushing for something she didn’t see as clinically necessary. And that’s probably okay to mention. I’d give it a couple months and come back if you need to.

So when I had a telephone call from her I requested this and she shot me down pretty much straight away. She said that she would want me to bleed for three cycles before they would investigate further. I was quite surprised and just said that I didn't really agree with this and I would like to have bloods and a scan like I did last time. She became very abrupt with me at this point and despite agreeing to refer me she made it abundantly clear she wasn't happy about doing it and even said to me "i'm not gonna sit here on the phone arguing with you when I have other patients to call". The conversation wasn't an argument. It was me expressing my concerns and her not reassuring me enough for me to feel happy leaving the call.

But you won. She agreed to refer you. Why did you then refuse to end the call because she was “not reassuring me enough for me to feel happy leaving the call.”?

GPs don’t have bags of time to get through all their phone appointments so I feel you were being difficult. You got what you wanted, why do the equivalent of bed blocking the phone line?

It's absolutely a reasonable thing for them to document. It's not saying you were difficult but that the interaction was a difficult one. It sounds like she did not follow the protocol that she was planning to follow and documenting that the call was difficult (I.e you were concerned and not happy with her initial suggestion) goes some way to explaining why she organised investigations. This can help colleagues to understand her logic later if they pick up the case.

If I read this in someone's notes it would just give me a heads up that it was potentially a sensitive issue and that I should be extra tactful.

I don't think they would be able to change their notes if you did complain because its an accurate reflection of what happened. The best you could hope for would be a note underneath the entry which would say something like "patient disputes accuracy of above entry and asserts that call was not difficult". Which, ironically, may make you sound a bit...difficult.

By all means, if you don't feel that you were dealt with professionally, talk to the surgery. But in response to your original question- the notes sound fine.

Although she did not handle it well, if you are demanding things because of your health anxiety she has a right to note that it is difficult when discussing what you want. She told you the guidelines - you disagreed with them because of your own anxiety - she gave in. You got the result you wanted. But she has the right to note that it was not an easy conversation.

OP, you should complain. People forget that GP is a service provider, she gets paid for this job. The quality of her service was poor and left you dissatisfied and upset. She was unprofessional.

And this is why we get so many unnecessary referrals from GPs these days. Under increasing pressure from patients for "something to be done" when often an initial watch and wait approach is perfectly justified in many, many situations. Fear of complaints from patients if they don't get their own way. Lack of time due to massive system underfunding to properly explain/discuss their reasoning to patient particularly when a patient isn't getting the answer they wanted/expected. Result of all this = quicker and easier to just refer for a scan or other test and so the waiting lists for said tests get longer and longer.

So you pushed for what you want and got it despite not really being indicated. And now you are wondering about whether to complain about the consultation being noted as being difficult, something which you acknowledge is true…???
seriously no wonder the nhs is on its knees.
and no wonder staff are leaving the nhs in droves due to unreasonable expectations from patients and unfair complaints

OP, I think you need to calm yourself and put it behind you.
It is a simple factual statement that the call was difficult.
It's time for you to move on and focus on your upcoming blood tests. I hope the results all come back well, best of luck.

The GP is a human too - complain about what?! This is someone's life!

Is this in England? Don't think we can see our notes in Scotland without paying.

The whole waiting 3 cycles before being referred is quite normal. I had bleeding in between my periods the once and I was told to monitor it for 3 cycles, mainly because sometimes you can get random bleeding which is completely normal. Even ovulation can cause some spotting.

However, having "difficult" call recorded on your NHS records is just bizarre. I'm not sure how that could be a helpful note in the future. I mean, are GPs going to start refusing your calls? I doubt it. So a bit of a pointless and unprofessional note really.

If it helps, as a nurse if I saw that in your notes I wouldn’t assume that YOU were difficult just that it was a difficult situation. Even if someone wrote that a patient was difficult I would still not assume anything, If she wrote that you were confrontational or argumentative I wouldn’t automatically assume that you were a always like that.

I hope you get the answers that you need.

@Ghislainedefeligonde @TheUsualChaos

I'm making a complaint because of the attitude and unprofessionalism of a doctor on a recorded call she made to me.
This isn't about the tests or the notes, it's the way I was spoken to.
I'm not the reason the nhs "is on its knees". I would absolutely encourage anybody to make a complaint if they haven't been treated fairly.

But thanks for your very strange comments!