What do you like/dislike during a medical consultation?

[Adviceaboutthis]

Hi!

I want to keep this anonymous but I’ll try and give as much information as I can!

im studying for a degree where I’ll eventually work as a healthcare professional in a sort of clinic setting, seeing and treating patients during appointments (think along the lines of GP or podiatrist appointments)

obviously we get taught at university about how to speak to people and help people, how not to cause upset and just generally how to be a professional and nice person and how to help patients in an emotional and practical sense. But I’m always worried that I could do more to help or be nice or that maybe there are things some people don’t like so I thought I’d just ask here!

Is there anything small that would help you, as a patient, during a clinical appointment? I don’t mean specific clinical knowledge or details, but was there ever anything a medical professional did that was particularly helpful or made a difference? Or on the other hand, made things worse or you didn’t like? For example, I remember a doctor recognising I was worried about a procedure and chatting to me about my pets and just generally being kind to take my mind off it despite how busy they were and i remember how much it helped me. I also remember another doctor saying yeah yeah yeah as I was talking and I felt like they were dismissing me and telling me to shut up

hope this makes sense! I just want to try and be the best I can be :)

I agree with SO much of the above advice.

Introduce yourself and what your job actually is. I recently went to an optometry appointment and saw 2 people, before the actual optometrist. Not one- not even the optometrist, introduced themselves, their role or what they were going to do- never going to specsavers again!

Ask how THEY would like to be addressed? Some people prefer Mrs Jones, others might be Barbara on her medical records, but has always been known as Jane or Babs. Others might prefer a gender neutral name or something completely different to what is written on their medical record- so check.

Ask how THEY would like to communicate. Some people are lip reading, so ensure you a face on and not turned away using a computer, others prefer to read written words.

I completely agree that you will never get it right, 100% of the time. Some people want it clear cut, others don't. People will nod when you explain things using medical terminology, and have no clue, whereas others will speak up and say that don't understand. Sometimes it helps to ask them to recall what you have said back to you. You then get an idea of how much comprehension they have.

I try to keep medical terms to a minimum, unless I know the patient well, their background and understanding of them. Its a hard balance of not patronising someone, but also not using terms they clearly wont understand. Sometimes this could be said as 'I'm going to speak to the orthopaedic surgeons, because they are the specalists in broken bones like your arm' or ' I need to call ENT, because ears, nose and throat specialist team are the best for advice on this ear problem you are having'.

Always ask if they have any questions, or they would like you to go over anything, or send them further advice on X condition or something in writing.

I’m someone with complex health needs rather than a clinician; & honestly, I couldn’t agree more.

People want - & need - massively different things from HCPs; just as HCPs find different ways of working suit them. Being responsive to patients’ needs (for example ensuring you don’t turn away from someone who lipreads while speaking) is of course important; but as Choppies said, you mustn’t take on responsibility for everyone’s happiness.

I get that you may have to take notes at the same time as I am talking, but please don't just sit there looking at the screen and typing. Acknowledge me: look at me from time to time while I talk, say "Mm hm" or similar when I make a point.

Use proper language. I once had a consultation during which the doctor was going to be touching my eyeball. He explained what he was going to do at each stage. So far so good. Then when we got to the eyeball-touching point I asked whether he was going to put some anaesthetic in. He got annoyed at me and kept repeating that not only had he already done it, but that he had told me he was doing it. After some irritating confusion I worked out that when he told me he would be putting "freezing drops" in my eye, he didn't mean that I should be prepared for a very cold sensation. Why didn't he say "anaesthetising drops"? Or "numbing drops"? Or specify what the "freezing drops" would do to me? To use unclear language, and then get annoyed at me for not understanding, and then refuse to use clearer language is really rubbish.

Definitely introduce yourself and anyone with you - and totally agree with other above posts.

I hate it when I attend with a grandparent who needs to be seen and they're talked over, talked down to or ignored while the doctor talks to me instead. They might have dementia but it doesn't matter, treat them with the care and respect that you'd give to the King and speak to them first, not me. I'm there as plus one, as a support.

I've gone out of my way to thank the doctors who treat my grandparent like the adult with autonomy they are.

Don't be patronising or dismissive.

Don't be arrogant.

Listen to your patient and talk to them respectfully.

Don't be offended if they have prior knowledge about their condition and don't assume they've been "reading rubbish on the internet" just because they've done some research.

Don't assume a patient is "anxious" because they want to see their results and want to understand their condition and treatment.

Decide on a course of action/medication etc with them rather than for them. It's their body.

Remember that they have to live with the condition, side effects of any treatment and the results of any misdiagnosis, inadequate treatment or poor decision. When they go home, they take it with them.

Get an understanding from patient groups about what it is like living with chronic illness and/or chronic pain.

Dont ask the same questions everytime to tick a box, and dont ask the questions if you are going to ignore the answers - no I dont smoke or drink much

dh went once for something else, answered the questions and told them how much he really drank (after difficult bereavement he went off the rails for a year and was drinking very excessively), the Dr didnt even ask why/how long for etc, didnt even look at him and said - well, try to cut back - then went onto next question. 🙄

Dont talk in an automatic patronising tone thinking it sounds caring. A Dr who is factual and knowledgable and takes action gives me more confidence than one pretending they care. I would prefer a Doc Martin any day 🤣

Don't ever let your patient know you think they are a nuisance.
I rarely go to the doctors and it takes a lot of courage for me to go (think once or twice every 2-3 years) but I often feel like an inconvenience. That doesn't do much to make me feel better.
A smile and empathy please.

On a similar note, the same can be said about (older) teenagers or young adults. I was diagnosed with a serious health condition in my late teens and had a lot of medical appointments for a few years. I took my DM along for support and some doctors would speak to her rather than 18/19 year old me. It was patronising and I hated being discussed as if I wasn't there.

Don't just assume that because patient is overweight/has had children/ticks a certain box that they MUST have xyz, or can't have xyz.
Believe what they tell you!
I find the nhs tends to pigeonhole certain symptoms, and also pigeonholes people based on "everyone who has" or "most people who do x" (this seems to be more prevalent for women who are overweight/have had children/have gynae issues)
Just please remember not everything fits nearly into a textbook chart, and most people want help so don't actually lie to the person who can provide the help.
And just speak nicely to people. It sounds daft, but so many medical staff make you feel that you're a nuisance or are really brusque or even downright rude, and when you're already low/worried/in pain, it can feel really upsetting. A kind word and a smile or a little bit of sympathy and understanding can go a long way.

I have 3 I dislike:-

1. Touching me with clammy, warm or sweaty hands - doesn't matter whether my arm, leg, stomach etc. I hate it

1. Use of overly medical terms, acronyms or jargon. Most patients don't have the benefit of medical knowledge- explain things with that in mind.

1. If in doubt, believe the patient. Most of us are telling the truth. I was over 10 years with Endo and continuously told the pain couldn't be that bad.

I would say that it’s important to listen to what impact the complaint is having on them. You may not be able to fix the issue but you may be able to improve their quality of life.

For example, I have worked in an area where we gave treatment for a chronic condition to reduce pain. One patient wanted to stop treatment due to the side effects the next day. We found out that they had their grandchildren on the day of the week following treatment day and spent the time struggling. We quite simply changed their day of treatment.

I have recently been to the GP regarding heavy periods. My iron levels are satisfactory but I cannot continue to work in my role where I am unable to use the toilet for long periods of time. A change of job would devastate me. The GP recognised that although it’s not a clinical concern it is a well being concern and has offered treatment.

I suppose it is just feeling heard.

Really important point!

Also bear in mind that no matter how together they might seem in front of you, it could have taken months for them to summon the courage / energy / strength to book the appointment and raise an issue with you.

Not to begin the appointment by saying "What do you hope to get out of this appointment?" which seemed to be the policy at my GP surgery for a while. Just seems patronising. Nothing wrong with just asking, how can I help you today?.

talking over me and then when I continue with my sentence they talk louder 🙄. This has only been male doctors now that I’m thinking about it.

asking ‘what do you think the problem is?’. I know this is something that’s taught because it allows the doctor to understand what the patient’s thinking but every time I’ve been asked that it feels like a trap to get me to admit to researching symptoms online (as if all patients are thickos who get their info from Facebook or something!)

Be prepared to accept you might not know everything and you might get things wrong. One of the better doctors I've come across basically said when I started the medical text books were this thick (finger and thumb), now they are this thick (indicates double) who knows what we will no in the future.

All the tests being clear is not necessarily reassuring when you know there is something wrong. It's just means it's something rarer , less known and/or harder to find

Don't expect to be trusted simply because you are a doctor. Seek to earn that trust be doctoring well

If a Dad takes their child to appointment don’t say “well we have to wait for mum” “wheres his mum” “make sure you tell his mum”. I don’t have enough fingers to count how often that has happened.

Don’t make the appointment about something else, I took my son to the GP recently as we thought he had another ear infection, it wasn’t his usual GP. My son has a minor limb difference, it has zero impact on his ears, this condition is in no way linked to any part of the ear in any sufferer. By the time the GP had stopped going about it the appointment was over, she hadn’t even looked in his ears, taken his temperature or done anything useful as she was too busy treating him like a circus attraction. That night we ended up in OOH as his ears were so painful, infection confirmed straight away and antibiotics given. If you have an interest in something thats fine, but a patient isn’t there to meet your needs, theres a time and a place.

Language around examining people, if a medic says “I need to” and then refer to touching you, or you having to take your clothes off I’m very likely to say no, someone not bothering to think consent isn’t someone I feel at all safe with. It isn’t hard to say “would it be okay if we looked at n” it also isn’t hard to ask if you would like a chaperone, it shouldn’t be up to the vulnerable person, in a strange room with a stranger to ask if one is available.

People who don’t have a British accent don’t need someone to speak slowly and loudly.

Wear a name tag because I will lose the information instantly what you said your name, especially if I'm feeling ill.

I hate getting medical care at all, I must be feeling diabolical or have screaming red flag symptoms to be there. Quick efficient and "positive thinking" is right tone for me. I may be irrelevant though, I get impression some people go huge amounts to doctor so they are majority of patients. Whatever suits majority of them is what you need to do, not whatever someone like me prefers. Most patients are elderly, right? Do whatever they need.

Not a farmer but .

Introduce yourself
Smile
Speak slowly and clearly
Allow the patient to speak and don't keep interrupting
Don't be rude
Don't be patronising
Don't tell them it's all in their head
Don't label everything anxiety or depression.
Explain things properly and ensure they understand
Don't make the patient feel like they are wasting your time
Don't rush
Don't make ridiculous statements.
Act like you want to help.
Be friendly
Tbh I could go on and on and on.
It basically boils down to be a nice person and treat the patient with respect and humility. Treat them how you would treat your most treasured loved one.

Use the proper terminology too. I once had a male gp refer to my vagina as 'down there'. Lost all confidence in him at that second (it was a gynae issue)

I had an appointment in February and the consultant wanted to know about my childhood. She said "if you don't mind, I need to ask your mum some questions"

I've had various procedures done over this last year. Whilst I'm aware what you're doing, still please talk me through what you're about to do. I've not had this; but I don't fancy suddenly feeling this needle in my arm that you haven't told me about!

Not being taken seriously or being patronised. If I’ve come to GP I’m worried so I want to be listened to.

Not explaining what the issue could be - I know that diagnoses can’t always be given at the time but it’d rather know what they are testing for or at least a broad outline.

i like a friendly manner, I need to be put at ease, so some general chat is good.

ive had some medical issues recently and On the whole I’ve found the professionals very good - mix of private and nhs.

I had a grim test and the consultant (private) actually put his hand reassuringly on my shoulder beforehand which was really nice.

That is so true. I get ‘what are you worried about?’
i hate that as obviously I’m worried it could be bad with weird symptoms/a lump etc!

To understand the difference between one issue = one appointment; and the patient trying to tell you all their symptoms in case it is relevant to the diagnosis. It's so frustrating to get shut down when you are trying to give the full picture. I am not the doctor; I am not to know that the occasional back ache I get is not related to the severe stomach pain I am consulting you about.

I really hate it when a HCP uses “we” as in “When our kidney tests come back outside the norm we really need to look at what our kidneys are doing” FFS.

Also, really elderly people tend to prefer to be called Mr/Mrs/Ms X rather than their given name, I’ve heard a lot of complaints from my parents’ generation about this. I appreciate that in a time of pronoun-sensitivity this might be a more difficult call, but just ask the patient, in fact have somewhere at the front of notes to record this once they’ve been asked once.

Introduce yourself and smile.
Appear interested.
Listen.
Don't assume the patient is an idiot.
Don't patronize and use 'we' or euphemisms for the body. I'm not a child. I work part time in health and am well informed. I usually say please talk to me as though I'm a junior doctor. If I don't understand, I'll ask. They then ignore this request.
Don't repeatedly suggest something if the patient tells you a good reason not to have it. I have lost count of the times I've been offered a coil. I have very good reasons for refusing. Listen to them.
Understand the person holistically. Don't assume they don't exercise or eat well.
Don't be a hypocrite. Obese health professionals lecturing on healthy eating and exercise need to address some of their own issues as well.
Be genuinely kind. I once politely asked someone the reason for something and they looked at me like I was a piece of poo on their shoe.

After years of hating GP appointments, I recently had a private consultation. The difference was enormous. It actually took up the same amount of time but the private doctor treated me like an educated human being, was thoughtful and helpful and didn't make me feel like I was a lump of meat.