Interrupting people in 1:1 conversation (mostly my GP)

[JFT]

Help me out here please!

OK firstly I'm ASD and struggle with some things when it comes to social communication - because I'm direct, open, straight to the point (not brutal, not insensitive, not rude) - and I cannot for the life of me 'read between the lines' or comprehend socially polite phrases that mean something different than the words. This causes a few minor issues not much. I get on well with people and my friends say I'm a good listener.

My situation is this - at the moment I'm under many many healthcare appointments as I'm awaiting major surgery. I also have some other M/H issues that I'm in treatment assessment for (relating to PTSD). This is all driving me nuts as it's my vast observation that healthcare workers (not all, but many) like to tell you what's what before having even debriefed you or heard you out. So they'll go on some upcoming big explanation of a thing that's possibly a) not relevant to my situation in any way; b) explaining in detail things I already know in detail; c) has already been way overshot by new developments / test results, new information etc; d) involves trying to book me in for something that's already been done and established; OK, all totally understandable, it happens.

BUT the issue is, my idea of being helpful and normal is to interrupt the person at the beginning and say 'just to let you know that's already been done' or whatever. I'm trying to be proficient and not have to endure an entire dialogue that is a total waste of time and them waste their breath too.

Same as if I met you in the street and you told me you were on your way to Argos to buy eight things and then you started describing them to me but I already know Argos is closed for two weeks. Am I going to say right at the beginning hey, sorry to interrupt but Argos is actually closed for two weeks? Well that's what I do. Usually in friends conversations they don't mind an interruption of that sort. I'm finding with healthcare professionals - nurses and GPs especially they cannot tolerate this interruption. Then they get angry with me and say things like 'can I speak please' or 'can you not interrupt me' or 'let me finish what I'm saying'. This is a repeat scenario and I'm struggling with it, they get really really annoyed and bordering angry - even I think they have me as a 'difficult / challenging patient'.

Say for example GP says 'OK I'm going to send you for a blood test to check your ferritin levels (and I literally just had that done on my way in the surgery) and then they bang on about a long winded conversation of what ferritin level means (and I am literally my own expert on managing my iron deficiency) and then they even start telling me which direction to find the blood unit (I know I've been there a thousand times, I was just there) and how long it will take for the results to come back (I know, I've had a thousand blood tests) and what the treatment will be if my readings are low and on and on and on (I know, I've been having iron treatment for a decade)... my version of not having to have that whole conversation is to INTERRUPT right at the beginning so as to save us all a whole load of time and effort and also assure I am aware. But this is causing me problems.

Is it me? I am suppose to let a person finish a whole long winded thing of unnecessary info before declaring that I already did that / already know that / this is not addressing the issue at hand?

What is the best way of dealing with these type of things?

If I didn't interrupt / dispute some of the stuff that's being said or done I'd be in a right pickle as I've been in a huge system fail with the NHS already so I haven't to try and keep on top of it all and not allow a healthcare worker to misdirect me - also this is a big part of the 'interrupting' as often the person is misdirecting me so I'm not just going to 'go along' with it or I'd probably be dead by now.

It’s well know that autistic people find navigating the healthcare system difficult, unfortunately. Some Dr do have a problem with what they perceive as their ‘authority’ being questioned.

Have you got someone who can go to appointments with you who can give you feedback on the interactions?

This is interesting / helpful to know.

I'm used to getting the same 'speeches' on repeat if it's something like say 'pre-surgery assessment' where they legally have to tell you stuff even if you've heard it a hundred times before. So those things are usually OK, although now I know if I get questions en route then I'll save them to the end and definitely not interrupt.

I have occasionally experienced this type of thing with consultants and it comes off kind of baffling as they deliver a sort of mini announcement with no introduction and no context. Also if they said, I'm just going to explain 'blah' to you and if you could listen and ask me any questions at the end, people like me would be like OK I can do. Otherwise I'm mistakenly thinking we're having a conversation / dialogue.

Example:

Genito-urinary consultant 'so we are going to insert stents in both your tubes from your kidneys to bladder and this will involve peeling out blah blah blah '

Me: (in shock having never heard about this before) 'will they be permanent'?

G-U Consultant: IF you could just let me finish what I'm saying!
(because when they got to the end of the lecture they were going to tell me they'll be removed in a few weeks and therefore my question would already be covered)

i’m finding myself nodding to everything you’re saying. It’s frustrating to be treated like that and I completely know what you mean. Every single time they have not told me anything new just the ‘script’

Sounds really tough, OP. Having read all your posts, it definitely sounds like to do with the WAY you’re interrupting, which they are perceiving as rude. You could try the following:

• Raise a hand slightly and say “Sorry [pause]” or “Sorry, just to say… [pause]”. Wait for them to pause speaking, then you can add your interruption. “I had that scan on X date, the results are on the system.” This should be perceived as less rude than actually talking over their words as they speak.

• During the beginning of the consult (eg first two minutes when they greet you/ask what’s up), try and get as much pertinent facts out in one go, to pre-empt them. “I’ve been referred to X already, I had my ferritin done on X, and today I’m just looking for….. etc”. This might feel a bit random/abrupt, but at least it gets it all out the way, and they won’t have to go over old ground.

Good luck!

I'm neurotypical as far as I know and I have had a lot of surgeries. I know exactly what you mean!

I was written down as "difficult/unhelpful" because I refused to have the same tests done by maternity that I'd already had done twice, the day before, by my consultant and midwife (I can read upside down quite well 😂).

I have had a couple of really fab consultants though.

I think hcp forget that whereas they do whatever it is all day, if we're lucky we only do it once or twice.

It may help to think of this in terms of game theory.

Your objectives: to get successful treatment; to clarify anything you don't understand; to avoid unnecessary reperition of tests and scans.

Their objectives: to cover themselves legally; to get through the interaction quickly; to pass you onto another department asap.

I got completely talked over by a paediatrician for my daughter, I'd waited nearly a year to see earlier this year. He was actually a good listener as his report was accurate, but my gosh he was a verbal steamroller!

If you can understand a bit where they're coming from it may enable you to meet your objectives more quickly.

I suggest also making notes before you go in of what you want to say, and afterwards about what happened.

If you feel comfortable disclosing that you have communication differences, then do.

Take someone with you if you can.

I had to deal with an unpleasantly aggressive nurse once and it was so helpful that my mum was with me. Afterwards she was able to confirm that I had been polite despite a lot of provocation.

That. I'll interrupt someone if they're suggesting a test that I've just had, or a referral to someone I've already seen.

But if they're explaining something that I already know, I let them get on with it. Interrupting in that case is basically just about pride and wanting to show that you're knowledgeable. But of course they a) can't read your mind and know that before they start and b) they have to be confident that you have the right info, and the only way to be confident of that is too know that THEY'VE told you.

So you can reduce the amount of interruption by just knocking the "but I already know that " stuff on the head.

This was really helpful!

With doctors I try to also give them a pre-briefing before they speak so they have the information already? Is that possible for you OP? So instead of them starting the convo you start it and rattle off all the things that you think are relevant for them to know.

Then as hard as it is, try to ensure you only interrupt in a natural pause in their speaking, and preferably once they have concluded their point so you’re sure your interruption is relevant and needed.

Finally, where they are just doing a “teaching” moment - just listen, even if you already know. It’s polite - even when it’s frustrating - if they’re not actually sending you off for the wrong scan then it’s only a minute or so of your time to listen to an explanation again and will do a lot to increase collaboration and good feeling between you and doc, which will only help you.

Maybe instead of viewing being told things you already know as a pointless waste of time, just look at it like a polite 3 minute investment into getting doctor on side.

Yanbu. I don't think it's about social convention but likely that they have to cover themselves by being able to say that the patient has been fully informed ,Dr's get sued left right and centre these days.Also if you interrupt they may lose their train of thought and leave something out, they're not perfect ,I know I'm a Dr's daughter 🤣.
You want to save them the time and energy,I totally get that, I'm inclined to politely interrupt as well, when you have chronic conditions you've heard certain info time and time again. I would be inclined to just bite my tongue and let them give their speech, unless there is something very specific they mention which requires you correct them or inform them.

Don't adapt to NT, that's not you. I'd be very clear that you're autistic, and they then need to adapt to you. Stay who you are, it's obviously working as you're progressing and taking no shit.

Hi OP.

I'm sorry to hear of your difficulties - I think may be sensible to let your healthcare team know that you are autistic and request reasonable adjustment. Have you considered sending an email to your GP or booking an appointment to outline the issues you have mentioned. The can put an alert on your record and ensure this information is in your referral.

@Phineyj

Thank you so much for this and the insight re game theory - wow you're so on point. I love 'Games People Play, Eric Berne' and also Transactional Analysis theory (I'm OK You're OK etc).

My game aim is conflicting with their game aim!

We're having 'crossed transactions' as the transactional analysts call it. And as the experts say, 'crossed transactions' create discord. Obviously in a hierarchy where one person has the power and control (not me, them) and also perceived 'authority' (also not from me, as I'm ASD we don't usually see people in those terms), if I'm interrupting and asking questions or disputing blurted info deliveries, they're maybe perceiving me as disrespectful and irritating.

I know they've got me down as some kind of 'insane' and 'difficult' before I even get there... I think it's flagged on the system.

I always take someone with me nowadays. Even if I have to drag someone from the bus stop and bribe them £20 (hasn't actually happened but I so would do). Things go far far worse when I'm alone.

I might get a big flourescent lanyard saying 'I'm autistic' so they at least don't feel so hateful. I realised one of the issues I've got is them thinking I'm some kind of 'princess' or 'Karen' (can't bear that name hate thing but YKWIM) being demanding.

Thank you, great idea, I will ask my autism support group for guidance how to do this.

Thank you for the supportive words. I'm desperately trying not to be perceived as some kind of self important pushy questioning disputing disrespectful person (I think there's issues to do with my physical looks plus being white and British that could lean them towards thinking I'm self-important) -but- it honestly doesn't matter what I do, they get me all wrong anyway.

I'm a bit unable to adapt it seems. So yes. I'll be me and they as healthcare workers can be them and try to understand a little bit.

Thank you, I shall do my utmost to desist from saying 'yep, I know... etc'.

The odd thing is that a lot of GPs and nurses seem to think that us non-healthcare workers operate in a world of oblivion and ignorance until they inform us of something. It's quite remarkable. I know they say don't google but honestly there's a whole world wide interweb out there telling us what we need to know if we're able to do a little bit of basic checking. I appreciate it's not a medical degree but wow I trust the internet about a thousand times more than my GP.

The problem is some people really don't know anything about their health, and want to be spoon fed every small piece of info, or act like they know more than they do, and the ataff don't know who is who. And for many things HCPs have to ensure you know X specifically, or are consenting fully to Y, so you interrupting with 'Yes I know' might not make sure they actually know or legal cover that you DO know EVERYTHING they were about to say. In some situations they do have to say clearly Z means ABC even if you already know.

I agree with the PP who said to try to limit those interruptions as far as your ND lets you - ultimately there is nothing wrong with double checking your knowledge and that the doctor is on the same page as what you were thinking.

But of course if they are suggesting things you've already had or giving directions to a place you know, there are ways to interrupt politely, even if it's waiting for a short break in what they're saying. HCPs should never be rude to a patient but I think most people being spoken over or interrupted do find it irritating.

Hope you can find a middle ground and you find answers to your health issues!

Iron causes rust, so your insides are unhappy when you have too much stagnated iron. It's meant to keep flowing round.
To get the iron to keep moving, we need to move most when we are injured. And we need to look at what is sucking up our magnesium levels.
Most health professionals will disagree with all the above despite knowing pregnancy is an inflammatory response which changes iron levels and why pregnant women should not take anti inflammatories.

YANBU and sound very thoughtful. But... I'm a GP and from my perspective I have ten minutes and only ten minutes per patient. Ridiculous, I know. The vast majority of consultations take longer than this, but such is the state of the NHS. The GP needs to keep the clinic moving or else risks running very late, which often makes subsequent patients quite angry. So while a couple interruptions might be doable, constant interruptions means the consultation goes around in circles, runs into the next 1-3 appointments and essentially disrupts the rest of the clinic (which can consist of 18+ patients) or even working day.

I might suggest writing down exactly what you want to get out of your appointment and then handing this to your GP when you walk in. This is your agenda, which is the most important thing. This will help yourself and the GP stay on the same page. Also limit your agenda to one complaint per appointment, so that it can be covered thoroughly and to your satisfaction.

I usually put my hand up like a child in school. Then people can see that you have something to say.

I might also give an intro in your case. Hi I'm neurodiverse. I cannot bear people telling me things I already know so if I make this sign it means I understand what you're saying and we need to move on to the next thing.

So you basically rude!

Multiple posters have pointed out that medical professionals need to tell patients some things to ensure patients have the correct knowledge and there's no comeback for themselves. They can't just assume a certain level of knowledge- how would they do that any way?

I can see why you are seen as rude and get short shrift. Especially since you still can't seem to accept this even after so many people have explained it to you. It does come across as more about your ego than anything.

There's probably some initiative they've got to follow around ensuring the patient has all the information.

The problem when you've got to do this is it takes over how you interact, you're thinking "am I doing this right?" "Have I given all the information I'm obliged to?" and that takes over your focus rather than focusing on the person you're interacting with. It also makes it harder for you to manage the sort of interruptions that would otherwise just be normal parts of back and forth conversation.

I think it's about how you interrupt. In this scenario you mentioned "OK I'm going to send you for a blood test to check your ferritin levels. Bla bla bla" I'd jump in with a smile on my face after the word levels with "ah, had that done on the way here." Personally I definitely wouldn't start with 'sorry to interrupt'

I have a similar issue, and I have a job where I need to interrupt often in meetings. That’s not fun.
Ive been experimenting with non verbal interruptions and it seems to go better. People hate being spoken over. It might feel silly but half raise your hand level with your face and they tend to pause. Or a similar gesture (I tend to raise my pen up in a point). I like online meetings for the hand raise function

I can believe though that you’ve encountered some difficult healthcare professionals. An example I had:

-my mum speaks yyy and would struggle to understand, can I attend the investigation with her? (Mum agrees next to me)
-oh don’t worry, a member of staff speaks xxx
-oh my mum speaks yyy
-they are the same language
-they are not, they are related languages…
-they are the same language with different names! They will understand!
-my mum would get a bit, but not technical words and understanding tends to go one way. Her replies may be not understood…
-it’s a cultural identity thing! It’s fine
-but it’s…
-it’s fine! (Leaves room)

The consultant got so angry so fast that I dared question his view of the two languages, but wouldn’t listen

OP I could have written your opening post!

I’ve noticed the GP / medic chat as a monologue is such a waste of time in an appointment! You wait months or years and then they monologue something you know is quite clearly incorrect if they’d taken 10 minutes to read your notes.

It’s uncomfortable having to interrupt but I think it’s important sometimes to be able to say what you need to say, eg) no we aren’t still waiting on that specialist scan, it did show x and y…

Could it be (their superiority complex and) sheer lack of time to familiarise themselves with your notes?

I like the idea of using the non verbal cue that what they’ve saying is irrelevant. Sometimes, the doctor just hasn’t had time and you’re doing them a favour by saving their time explaining something that is unnecessary.

I know it feels uncomfortable OP!