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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think this GP comment was a bit daft

67 replies

Juno999 · 31/07/2023 04:55

I had a GP telephone appointment wrt to mental health issues, then a couple of months later I had an in-person appointment for a UTI.
Whilst in the GP's office, I saw my patient file was open on his pc. He left the room to get something and I had a quick scan with my eyes from where I was sitting.
He'd referred to my previous telephone appointment in which I said I'd felt depressed and he'd written 'She actually sounded bright and cheery over the phone.'
I just thought it was a strange comment really, someone can sound bright and cheery yet be going through mental health problems, or maybe that's just how I sound on the phone, or maybe I'm trying to mask it. All sorts of reasons, it just felt like he was minimising it almost.

OP posts:
KrisAkabusi · 31/07/2023 08:28

Juno999 · 31/07/2023 08:27

Yes perhaps he shouldn't have left the screen open like that

Don't blame him for you being nosy!

Original poster
Juno999 · 31/07/2023 08:29

So I should have deliberately looked the other way 😂 ha

OP posts:
RosaKim · 31/07/2023 08:30

Can GPs do anything right?

YeahOkWhatever · 31/07/2023 08:31

It's a comment on how you presented, not how they think your mood was. A psychiatrist will always comment on speech patterns, flow and how mood is presenting etc
This is why people should not read their own medical notes out of context as it can be anxiety provoking.
I hope your mental health is better now.

Rathouse · 31/07/2023 08:32

LightSpeeds · 31/07/2023 07:04

I make full notes for the phone calls I make at work on clients. You just put down the FACTS of what was said (and how it was said, etc., if appropriate). It's not a judgement or an opinion.

This

greenteaandmarshmallows · 31/07/2023 08:37

Juno999 · 31/07/2023 08:29

So I should have deliberately looked the other way 😂 ha

No but its a bit odd to suggest a GP should hide notes from the patient.

Twyford · 31/07/2023 08:42

I think it's correct to record this, just as a lawyer would be right to record factors that are a potential weakness in their clients' cases.

Floatlikeafeather2 · 31/07/2023 08:44

CakeIsNotAvailable · 31/07/2023 08:02

It's part of what is called the "mental state exam" and it's a helpful part of assessing mental health issues, including risk. As others have said, your GP probably didn't mean to imply you weren't really depressed or were lying - just that you were, despite your low mood, able to compose yourself for the call. The management plan and risk profile might be different if you had said very little and spoken in a flat tone of voice, or if you had been speaking very quickly and mixing up different trains of thought.

During a phone consultation, your GP has less to go on - they can't see how you look - so tone and content of speech is a helpful part of the assessment.

I am a doctor myself and I find it odd and jarring to see my own medical records when shown - the specific language and phrases can sound quite judgemental (e.g. "patient denies headache" rather than "patient reports she doesn't have a headache"). The language and content of medical records can read oddly and can be quite archaic.

That is actually a bit worrying because "patient denies headache" doesn't mean the same thing as the patient saying, as part of a list of symptoms, she doesn't suffer from headaches. What it means is that she DOES have a headache but refuses to acknowledge it.

Justgonefishing · 31/07/2023 08:47

i think it does depend on how they put it into context....sometimes people who are actually going to put a suicidal plan into action can sound "better" because they have made a decision about how to resolve their mental health struggles. i think its a whole other level of skill to assess people via the phone which is why the current health system is failing so many people.

Willmafrockfit · 31/07/2023 08:48

how is your mental health now?

lljkk · 31/07/2023 08:58

They have to write how you present.
Imagine you presented saying "I'm fine really, don't worry about me!" while trying to slit your wrists in front of them. He's going to note what he could observe, not just what you say about yourself.

"Actually" sounds surprised like he's perfectly aware that it's a huge contrast to the rest of the history he's hearing, like he well-knows you could be masking. Knowing about masking should be part of professional training.

Also GP needs to risk assess if you might be imminent danger to yourself, that's part of noting your mood, recording reasons why he didn't put you up to be sectioned for instance.

FrenchFancie · 31/07/2023 09:01

When I had terrible PND I would frequently turn up for my appointments with wet hair in December because I knew I needed a shower but didn’t have the energy to dry it, so would just go out with it wet. When I started to feel better I was able to wash and dry my hair and put on make up again, it was noted in my notes. I recall seeing it at the time and wondering if this was some kind of fashion police judgement, but now can see that it was the early signs I was turning a corner.

electriclight · 31/07/2023 09:16

ActDottie · 31/07/2023 08:13

I have all sorts of MH issues and I definitely mask by being bright and cheery! It was okay to make the comment I think but he should’ve followed it up by saying you were potentially masking.

Does he need to waste time typing superfluous information when any professional who reads the note already knows that?

I don't know when the general public decided they have the right to amend the recorded observation of a medical professional. They'll be writing their own next.

Justaddalittlespice · 31/07/2023 09:16

This is something iv struggled with most of my life and I try and see it from the gp and mh workers side but It is really hard when it feels like your feelings are minimised. I think with any invisible illness you spend a lot of time trying to make people understand that your not ok and that your not just being lazy when you can't do something. So when your also feel like the professionals also don't understand the severity of your struggles its really hard. I don't understand why this is acceptable in mental health but not in physical health. If someone broke their leg would a doctor write they walked into the room perfectly fine, wasn't in pain and was dressed appropriately (maybe they do I don't know) it just seems wrong.

sgtz · 31/07/2023 09:16

I see lots of patient’s medical records at work and it’s absolutely normal for presentation to be recorded in this way. It’s quite matter of fact, but I wouldn’t interpret it as an implication that they believe you not to be depressed. Also, I always try and get a good look at my notes when I’m in for an appointment as I’m so nosy!

Original poster
Juno999 · 31/07/2023 09:17

There's a contradiction. So I've been told it's odd for expecting them to hide notes from patients. Then I've been called nosy for reading them! So which one is it then?

OP posts:
Justaddalittlespice · 31/07/2023 09:19

electriclight · 31/07/2023 09:16

Does he need to waste time typing superfluous information when any professional who reads the note already knows that?

I don't know when the general public decided they have the right to amend the recorded observation of a medical professional. They'll be writing their own next.

Show quote history

I'd love to write my own, my medical records are full of lies, which other drs take as fact and its really hard to get stuff out of your medical records even if it's so obviously wrong. I was misdiagnosed with cancer years ago and that took a couple of years to get out of my record

TarquinOliverNimrod · 31/07/2023 09:19

The word ‘actually’ is the issue

Justaddalittlespice · 31/07/2023 09:20

Juno999 · 31/07/2023 09:17

There's a contradiction. So I've been told it's odd for expecting them to hide notes from patients. Then I've been called nosy for reading them! So which one is it then?

I'm with you I would and have in the past read them, there your notes and anyone can request to see their own notes

MrsBigTed · 31/07/2023 09:34

Floatlikeafeather2 · 31/07/2023 08:44

That is actually a bit worrying because "patient denies headache" doesn't mean the same thing as the patient saying, as part of a list of symptoms, she doesn't suffer from headaches. What it means is that she DOES have a headache but refuses to acknowledge it.

Show quote history

But in medical speak it means, "I asked if the patient had a headache and they said no"

SirSamVimesCityWatch · 31/07/2023 09:40

I would expect they know that patients mask. But being able to mask is something to be noted, in my experience. I only contacted my GP when I couldn't mask any more - I was the patient on the phone unable to form full sentences, gulping air and unable to stop my voice shaking and cracking. It took probably two months for me to be able to get back to be able to do a normal phone conversation. So I think it's a fair thing to write in notes.

I would be concerned about it, however, if I felt I wasn't being treated appropriately or taken seriously overall. Then it would be part of a bigger picture.

drpet49 · 31/07/2023 09:41

RosaKim · 31/07/2023 08:30

Can GPs do anything right?

This. What a stupid non issue.

WhateverMate · 31/07/2023 09:43

There's nothing wrong with him noting you were masking on the phone.

SirSamVimesCityWatch · 31/07/2023 09:49

As a side note, this is why doctors used to be told to develop that scrawly, messy handwriting - to stop patients reading their notes!

Georgyporky · 31/07/2023 10:08

Juno999 · 31/07/2023 09:17

There's a contradiction. So I've been told it's odd for expecting them to hide notes from patients. Then I've been called nosy for reading them! So which one is it then?

GPs can't hide notes, & you're not being nosey wanting to read them.
You can ask for access to your GP records, & the surgery must grant access.

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