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 :)

Not to be patronising, don't talk down to the patient.

İf a patient is worried don't say 'oh we've seen this thousands of times' the patient hasn't and has likely taken a lot of courage to go to be seen and heard.

Don't dismiss anything. A lot of patients downplay symptoms as they're worried it's serious and aren't emotionally ready to deal with it.

Don't talk to patients like they are two years old.

Smile, make them feel at ease, make them feel heard and reassured.

İf they look upset, don't say 'im sorry we don't have time I have other patients waiting' the patient may never come back.

İf someone admits they can't cope/struggling, it's taken a lot of balls to admit to this, it may be a million times worse than they are letting on. Find out how you can help or if they have support.

Not to ask me what I want from the appointment, or what I want her to do about whatever it is.

Justto ask what's wrong, and then for her to say what needs to be done - if there are options, tell me where there are and what the advantages and disadvantages might be, and then which one she'd recommend - but still allowing me choice if I particularly want the other one.

Not just saying "wait and see" or "try this simple self-remedy" when I have waited six months to come in anyway - she can see from my records that I don't come in often or instantly when there's a problem, so presumably I have tried things - and even more so when I tell her I've tried all those things!!

Not just dismissing something and saying losing weight would help etc, of course it would and I'm working on that, but it's not going to be instant, and in the meantime I need treatement for whatever it is.

Acting like she cares or remembers me as a person always helps. I don't get that now as I never see her often enough for it to happen, but even if she doesn't remember me from one time to another, there are ways of acting like she cares what happens to me, wants me not to be worried about whatever it is, sympathises with something being difficult etc.

Minor symptoms can still be majorly annoying. Something might not be the worst case of whatever that she's seen or heard about, but it doesn't mean that it might not still be that illness/disease/condition.

I think you will get far by just treating people as individuals and actually listening to them.

A huge issue is doctors/nurses patronising patients - it's understandable to a degree because there must be a lot of people who worry about things that are really not a big deal, and the doctors feel they have 'seen it all before' and know what it is. Just a bit jaded by the job I guess.

However, I think that is how things can get missed, and patients end up feeling devalued and not listened to so they sort of give up.

My biggest tip is to always assume people have the capacity to understand what you are saying. Explain things properly, listen to people's concerns and don't brush them off.

Introduce yourself and address the patient in a way that infers the patient is your equal. If you want to use the patient's first name offer your own. If you want to be addressed formally, address the patient formally. If the child is a patient, never ask "are you mum"; ask "are you John's mum". In conversation also it's "your mum" not just mum. And never call the parent "mum". The parent is the mother of the child, not you.

Listen carefully and engage brain before mouth.

Respect the time of your patient.

Explain why you have reached your conclusions.

Be clear and transparent about waiting times and the next steps.

If there are delays and errors, explain and apologise. Don't make excuses and blame funding. In fact don't complain about your employer (the NHS) to any patient. It is very unprofessional.

Don't be a patronising dick, not even to women in their early 20s, even though you know full well there is never anything wrong with them other than worrying about their appearance. Also when they come to you about a specific non-gynaecological issue don't waste the appointment they had to take time off work for by pivoting into an interrogation and then a lecture about contraception which they have expressed zero concerns about.

Introduce yourself name and role if you are not a Gp. Quite annoyed that my practice have introduced both ANP and physician associate to me as “ booked with dr xx “ . I absolutely appreciate you may be great at sorting my issue but if you can’t sign a script ( the PA) I’m going to be fed up (PA was a bit rubbish. Did nothing , scripted what I said 😂 without asking what I do / how I know the ANP Was better )

I had an accident over 20 years ago which was really horrific and gives me some ongoing issues. Please try to read my notes before meeting me but also please don't bring it up unless you need to. 20 years on and it still upsets me when I have to talk about.
Be human, eye contact, listening and also don't be patronising.
I have two adopted kids, they are mine, I am real, don't ask me if I am their real mum and be aware of their medical background and pre-birth trauma.

Don't feel that you have to be too 'nice' - give the patient what they need. As an example, I went to the GP with a hacking cough that was making me miserable. He told me that the cough would clear in a week but he then advised me that I should get my acne treated and handed me a prescription. I hadn't even been aware that my teenage spots were that bad but I was very grateful that he made use of the appointment and acted in my best interests even though I was a bit taken aback!

Please do tell me your name - either your first name or your title and surname, but please not Dr Kate, Nurse Susie etc as if I’m a child and it’s CBeebies (if even if with my child)

Please call me by my name and not “Mum” if it’s an appointment for one of my children.

Explain what you’re telling me - I don’t have a nursing degree, I’m not a dr, but I still want to understand what’s going on. I am certain I’m a fairly intelligent person but people always seem shocked when I ask “what does that mean” so I get the impression many others just don’t ask.

I think you're doing well already (because your asking and thinking about the patients).
As an ex health care professional, who's now retired on ill health grounds I've had plenty of experience from both sides.
My top one is honesty - don't lie to me or give me half a story, if I'm going to be on the waiting list for 4 + years tell me, I can get my head around it and not feel everything you say to me after that is a lie. I know it's not your fault the list is so long.
Holistic care - I'm forever being told exercise will help, but I can't exercise because I have severe cf which they'd know just by scanning my notes.
Check what other stresses/support patients have. Don't assume patients have a good support network, people with chronic illness often find their friends/family disappear. They also may not want to put upon others because its not short term support its long term. They also may be a carer (I'm disabled but also a carer) with all the stress it brings.
Benefits have a big impact on patients, the stress and worry of the governments reassessment process for health benefits is hard, long and repetitive. I was due for pip reassessment in February I'm still waiting the worry is overwhelming at times. It has an impact on other things like blue badge as patients need proof of need. That one letter you write in support of your patient could be life changing.
Communication especially if your seeing some one repeatedly, patients like to know you have a connection. Don't divulge your life story obviously but knowing you understand/have something in common helps. Dc2 has a dietitian who's son is same age so talks to dc about life experiences that are relevant at that time over time its helped to build a relationship.
Good luck with your future career.

I always struggle with answering that. I sometimes know because I've had it before and it presented the same. But I sometimes don't know and don't want to make it sound like I'e googled and it's the first thing that appears to match my symptoms. I was told off for doing this by a receptionist. I had the condition before and had similar symptoms.

Most patients are stressed before they get to the consulting room by the treatment from reception staff and the booking process,
have a private area for patients to talk to office staff about their prescriptions/next appointment/ailments,this should not be optional the waiting room should not also be the area where you speak to staff no one wants to be overheard or in fact listen to other’s problems.
make sure front line reception staff have excellent people skills and are well supported in their role. Make the website and booking process easy to use so that patients aren’t already pissed off when they walk through the door.
Explain to patients before hand how to be good patients, moderate expectations ., not sure how you’d do that though, probably have a section on the website leaflets and notice board. Could be called “how to get the best from your 6 minutes with the GP”

Being empathetic. I had a horrendous time with my dd eye when she was two. First consultant couldn't have been more dismissive, he it wasn't life threatening and he may see loads of them in a day, but it is distressing when she is in pain and leaking pus from a lump under her eye.

We got referred for a second opinion and the next consultant couldn't have been better he acknowledged it was distressing and said that he had had grown adults crying to him with the same condition. (He also gave treatment rather than a brush off) but the difference between being made to feel I was overreacting and being listened to made a massive difference. Don't go into health care if you are going to see you patients as an inconvenience!

Not just saying "wait and see" or "try this simple self-remedy" when I have waited six months to come in anyway

This is true. If something has been going on for a long time, or if the person has already seen other HCPs for the same condition but it hasn’t improved, please don’t act as though you’re at the very beginning of dealing with the problem.

The GP I see more often than others has a lovely way about her, interested in her patients and holistic.

A friend recently having treatment for cancer was asked how much they actually wanted to know. Some people don't want detail, it makes them panic, but my friend wanted to know everything. The team actively wanted to adapt themselves to my friend's preferences, which I thought was brilliant.

Thought of another one. Don't assume that everyone is a time-wasting hypochondriac. Seems to be the default assessment before even listening to symptoms or examining someone.

I had a procedure today and this is my take on it:

• consultant was running late - receptionist only told us (me and other people waiting) until well past appt time and I had to ask for an update which was annoying as I was getting stressed.
• he did apologise once I went in and said his last clinic ran over which I would’ve been less stressed about if the receptionist had explained. I thought he may not have turned up!
• he introduced himself
• he was pleasant and his nurse/assistant was nice and asked if I was ok a lot and I held her hand for the painful bit!
• he explained what he was doing at each stage which is very important to me.
• didbt say much about aftercare but it was explained on the consent form

Oh no I like it when they type as I am talking. I can then see exactly what they are typing and correct them if they type something wrong. They also aren't relying on memory after the chat. I want it to go into the notes as I say it

As a former clinical hcp here are a few:

listen and hear. Pay attention.

before the patient enters take a few moments to review their notes. If you’ve met before acknowledge this. If not show you’ve bothered to read their referral.

Chat but don’t waste time. So aim your questions at topics relevant to their health issues.

Not to be referred to as "mum". When this happens I say "oh! My name is xxxx" .
If this is disregarded, it's very hard not to feel patronised. I've had conversations where this was ignored several times and further attempts to say "please call me xxxx" were also ignored.

The last person I spoke to via 111 picked up on me giving my name, said "oh, sorry, my name is xxxx" and I was very impressed at the emotional intelligence it took to do this.

Also, if you send material out, please make it age appropriate. My 11 year old was sent information that constantly referred to behaviours of a much younger child. It was meant from her to read but I felt if I showed her it she might be upset and also likely to disengage from being proactive with her own treatment. By the time you have a tween , it's necessary they are onboard with it.

Read my notes. So fed up of having the same conversation over and over with my GP. Would save so much time if they read what was written last time.

The best doctor I ever saw was one that took the time to introduce himself and let me know that he has a policy of treating all his patients the way he’d like a doctor to treat his kids. I was a teenager at the time and it really put me at ease after seeing so many brusque doctors that gave the impression that they wanted to get me in and out as quickly as possible. He was apologetic when carrying out uncomfortable procedures and I went from being extremely nervous of hospital appointments to not minding them.

I have a very rare progressive condition that very few doctors will ever come across. Please realise that in a lot of cases the patient will know more about their condition than you. Understand when I say no I will not stop or change my medication regime until my specialist Dr /nurse has confirmed it is OK for me to do so.

I use the online triage system on my GPs website and I really like the questions on the form. It really helps me prioritise what the problem is and what I’d like from the consultation. The questions are what is the problem. When did it start. Is it the same or is it getting worse. What are you most worried about . What would you like us to do.

ive got a genetic condition and I feel like I’m playing whack-a-mole at the moment trying to get various problems into a containment situation. With my back problem I’ve been passed from MSK team, pain management, physio but what I really want is for someone to try find out why the joint is getting more unstable and maybe do an MRI. It’s beyond physio. I want someone to take it seriously as i can feel and hear something moving out of place and it’s really frightening. I put on the form I’d like someone to take it seriously and not get passed from dept to dept. The GP asked me to come in and was amazing. She could see I could hardly walk and did the consultation standing up when I said sitting down was the most painful thing of all. She was sympathetic, helpful, gave me stronger painkillers, arranged an X-ray and to see an MSK doctor not the general team. It was so reassuring to feel someone wanted to move things forward and was kind and sympathetic as well.

In my experiences:

• Don't use any patronising names like "mum or sweetie" and explain things as you go.
• Say sorry if you are running late (takes the wind out of our sails when we are angry)
• Actively listen to what your patients tell you (medical history, despite what's on their notes)
• Explain as you go - This one helps me with anxiety and it's nice to know if you are unsure with a procedure/treatment/test the healthcare professional is carrying out.

Keep your marble jar full, look after yourself in order to look after your patients and good luck. 👍