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.

I wonder if they also have a professional duty to give you that information.

They meet all sorts of people who might say they've done something or they understand something but in actual fact that's not actually true. At least if they have given the information personally themselves they KNOW that the person has been given the relevant information even if they don't follow it.

It's tricky because some of it will be judging the situation. I might interrupt and say I've had a blood test, giving relevant information to show it's true. On the other hand if they are giving me a long winded explanation of a series of tests I might let them go through it for their own peace of mind, even if I'd googled it before hand, iyswim.

If you always had the same GP, what you do would make sense. But if you have a random one from your Surgery, then it is part of their job and you should let them say it.
Bar the case of ordering a test that has just been taken, as on the very same day.

I think it's my increasing frustration with GP and going through repeat loops of fobbing off - but it's like I can't quit asking as the issues are serious and urgent, profoundly negatively affecting my whole life. And they can't / won't progress anything for whatever reason.

You've had good advice in the thread but this jumped out at me OP.
I'm wondering why these issues aren't being progressed? Have the reasons been explained to you but you're back again asking the same questions? I can see that would cause frustration on both sides. Are you getting frustrated about NHS waiting times?
You say places have already declined a referral, has it been clearly explained why they feel that isn't an appropriate course of action?

I think the idea from the GP on this thread of writing down what it is you want to get out of the appointment is good. And that may also help you and the GP to see at the outset if you/they have covered this already.

This:

HCPs have a professional duty to explain what they're doing/proposing and why.

Comprehension levels vary and some people really are experts in their own health and healthcare and some people are not.

And some people get the wrong end of the stick and/or pick and choose what they want to hear.

HCPs have to be, and I know not all are; really clear in their communication otherwise you get misunderstandings thar can have much bigger implications.

Like others I interrupt if I can see they have missed something in my notes, or about to prescribe something I can't have (happens a lot, I have a rare condition that most GPs know little about )

But if they are just telling me stuff I already know then I just listen politely. They are probably obliged to tell me and of course they can't accurately ascertain each persons knowledge level

I am autistic and love this idea <nicks it>

Unfortunately your GP does not have 10 minutes to read your notes and it isn't reasonable to expect this. They have 10 minutes to read your notes, see you, listen to you, examine you and then document the consultation. This is of course under the NHS. I have friends who work in the private sector who have 20-30 minutes per patient, so they would have more time to read notes and familiarise themself with a case.

Can I just say as an ND person, what a great thread this is. So much really helpful, non-judgmental advice for the OP. And the OP seems lovely too and very thoughtful and self-aware.

I know what you mean OP, I find it a difficult relationship because you know more than they do, but they also know more than you do iykwim. From your point of view they are not taking your expertise/knowledge into account, but with the interrupting they would probably say the same about you. There is some really good advice on here though.

Mostly I think the problem is time - I always feel that HCPs are desperate to get rid of me, which I know is not their fault but I find it very discombobulating.

I have an ASD DH who has a special interest in classic cars. I sometimes wish he would make me a laminated handout with the key bullet points about his beloved motor, for when I get cornered by other similar enthusiasts.

This thread is making me think those of us with complicated medical histories need a laminated sheet!

I can't relate to the health care side of things but I am horrendous for interrupting conversations, at work, home, anywhere.
One of the things I've subconsciously started doing is slightly raising my hand with a sort of sorry smile to the person speaking so when they're ready for me to interrupt they can invite me to. But I then have the problem of remembering exactly what I wanted to say, which then means I don't focus on anything being said after that point until I can speak.
I've also had it by where I've not been able to interject, and the conversation has moved on which means I then take the conversation backwards. Its very frustrating.

If your comfortable to do so, I would suggest a lanyard or outright starting the appointment with something like 'I do have Autism and I may need to interrupt you in order to understand everything your saying'
Because if they think you won't understand rather than just interrupting, they're more likely to be receptive to it.
GPs do see a lot of people who use Dr Google and I imagine (they don't have time to read notes throughly unfortunately) they probably get frustrated with their degree being questioned by someone who googled stuff at 3am and thinks the doctor is wrong.
That's not the case for you OP, but they don't know that because they aren't given chance between appointments to actually read notes.

Or I'd probably seem like a horrendous patient that starts with 'I'm being treated for x,y,z. I've had this scan, had a blood test for x, another one yesterday for Y and I'm on Z medication'

Just wanted to say thank you for all the thoughtful replies, just to clarify a tiny bit

Re what I'm ultimately trying to manage is waiting for so called highest priority of urgent surgery - supposed to be booked in within four weeks.

It's a big surgery and also a cancer investigation. The symptoms have crippled me and are also scary. My life is affected all day every day with the symptoms. Plus this has profoundly affected my mental health as it's something that resonates with trauma from abuse I have (the physical symptoms). I didn't really want to bang on about that as I've mentioned it in other threads.

But I have a lot to try and get through with the NHS and I'm being chronically fobbed off. My GP literally isn't helping.

Thus far since last March I've been wrongly discharged by the hospital twice, then when put back under the hospital and assured I was an urgent case found out I wasn't even on the wait list, had been recorded as 'watch and wait', then put on the wrong wait list (one for over 18 months), then recently I was referred to the wrong hospital for the wrong surgery type of surgery so the surgical booking team had to cancel the referral. So I have to keep checking, chasing things up, trying to establish facts, as polite as I can, whilst also attending lots of medical appointments and scans and speaking to my GP on other issues. It's a lot but I'm still no further on, I still don't have a surgery date. I feel like they're fobbing me off from needing to do the surgery as it's extensive - unsure, that's just my suspicion of what's going on.

Meantime, I'm not being listened to, being spoken 'at' a lot, and having to interrupt a lot or the appointment would end and I'm out the door and nothing's been addressed. Plus I speak to my GP on other things and nothing ever gets resolved either. So my personal aim is to always try to establish facts and try to move it forward.

That idea wouldn't work for the OP though because they're not saying they interrupt so they can be sure they understand, they interrupt because they've already decided what the HCP says is irrelevant.

I'm afraid to say your point here is true...

I mostly interrupt as I'm aware was the person is about to say is totally redundant to my case. It's not like they're needing to tell me something important. It's usually that they're about to misdirect me into a loop I've already been through.

Obviously, I'm totally aware that me deciding what someone's about to say it pointless can come off as really really rude, but I'm usually correct. Also a bit off topic when it's not in these difficult settings, people I know say I'm a brilliant listener and totally 'get' what they're saying, that I'm very perceptive and they're glad of me understanding them and I do genuinely hear people out and debate / discuss their issues with them. I wish someone / anyone would do the same for me! (Altho here on this thread MNs have been doing, so thank you).

I am supposed to have a regular GP but she's flaky and forgetful (or rather, has a thousand other patients), off a lot, and also forgets to book me in sometimes. I get on OK with her.

Hi OP I can understand your fear , anxiety and frustration with everything you are currently going through. And none of us, ND or NT will communicate ‘perfectly’ when we are in distress so please don’t worry too much about that, instead focus on achieving your aims.

I think , if it’s the GP practice where you mostly have trouble, contacting the practice manager may help, to ask for reasonable adjustments in your consultations. These might include: them facilitating you seeing the same GP each time for consistency wherever possible (this will help reduce ppl covering old ground), a double appointment time, them supporting your communication style and being patient with your questions and comments, them being open to your bring a written summary or list of questions you would like answered today, them checking your understanding before explaining something to you.
Really it is they who should be adjusting to meet your needs not vice versa, although I understand why you are trying to do so, you are spend lots of precious mental energy on this.

Also, at the hospital, you can ask for the learning disability team to support you (I realise you probably don’t have a LD but they also support ND people), they can help advocate for you and support with navigating all these different teams. I have found them to be great patient advocates, acting almost like a PA so the patient doesn’t have to do all the liaison.

I get a bit too hasty and too repetitive with my interruptions

I suspect this will be more of a problem than the interruptions themselves. Unfortunately this has become a thing for you now and you're on heightened alert for it, feeling actual pain having to listen, and jumping in more often and unpleasantly, so you're wound up, they're winding you up, you're winding them up and it's a dispiriting encounter all round. I definitely think some of the advice on this thread will be helpful, and also in using that advice, if you can try to mentally reset so that it's not going in with all that stressful baggage of past interruptions, the images in your head you've come up with about it etc. then you can hopefully be less tense to start with and if you do have to interrupt, it's only about that particular instance, not this world of pain from all the past issues. I'm not saying you're wrong to have felt that way, but it's not helping you to start the encounters on that level of tension. It must be exhausting for you and for them.

Also your example of the stents where you wouldn't have interrupted if you'd understood that they like to explain everything first and take questions at the end - and that your panic/question about if they were permanent would have been answered if you've waited. Now that you know that, can you assume that's the case with those conversations without them needing to say it up front? Because that's a very different scenario to the telling you to have a test you've just had, which is worthy of an interruption. It's worth assuming they'll get to telling you the important stuff if you wait and listen, and ask at the end.

Back to my earlier suggestion of an intro - I would start by saying that you don't feel that you are being taken seriously and that you really need them to listen and make sure you get the correct treatment.

I think if possible book a double time slot. That gives the hcp a tiny bit more room.

Definitely book a double slot. Also if possible, make up a list of what has happened to date, as brief as you can make it. i.e.

I am being investigated for X

• I was referred to X department on X date - nothing found
• I was referred to Y department on Y date - nothing found

I am here today for Z.

This way when they go off down a previously covered tangent, you can hold up the notepad and point to that item on the list. Still interrupting, only silent this time.

If you're feeling PA, write 'I have prepared this list so as to save time and not go over old ground again' at the end of it.....

Yes, thank you, this is good advice

I'm going to do a bit of praying and meditating and do a mental 're-set'.

The last four years have been too much, too overwhelming, too distressing for anyone to really bear, involving minor surgeries and lots of examinations and scans etc, and many frustrations and difficulties and bad news. The fact that the NHS and GP practices have been in a crisis due to covid / staffing levels etc through most of that time has been awful for all involved. That I have added communication / processing / comprehension issues puts extra stressors.

However, it's time to take on all this new information and adopt these ideas - all of them! They're fantastic! And start with a mental fresh slate.

I've had some amazing and brilliant advice and suggestion on this thread, honestly can't say how mind blown at how kind and thoughtful people are (a tiny bit hurt at the more critical ones but they are the minority and anyway they may even be right, I'm not perfect, maybe I'm a nightmare - this needs to be considered as one aspect, it's undeniable).

My head is filled with new ideas, new approaches and I feel quite a lot more empowered and way less antagonised / antagonistic towards the healthcare professionals.

This thread has been better than 12 weeks of therapy!

Thank you :)

I'm going to ask for face to face appts with my GP instead of telephone. She did offer this recently, where her previous habit has been to call me as it saves her time, she can find me a place in her busy day 'in the morning'. Unfortunately this tethers me to my phone in a state of anxiety also 'all morning' and sometimes (rarely) she doesn't ring at all.

I thought I was being a helpful component in her day schedule by agreeing to this since I'm not employed or occupied but actually I was people pleasing and making my own life stressful. As I even get anxious to go to the loo in case of missing her call.

I realise that in person, non-verbal comms can be more useful than verbal interrupts and speaking over. Also facial expressions and body language and 'sign language' gets lost along the way in a phone call.

I would rather build a face to face relationship with her and will address this.

Definitely go for face to face. Good luck with everything OP

No, she’s neurodivergent/autistic and struggles with aspects of pragmatic language use (using and understanding language in a social context). She’s not rude at all. The world would be a much better place if all of society were as accepting as most of this thread are. I’m a speech and language therapy student - also neurodivergent - and I’m bloody delighted reading this thread, that so many people are understanding and willing to offer advice without judgement.

Brilliant, that all sounds really positive and the meditation must surely help. Take care and all the best with putting it into action.

I'm sorry you're going through such a worrying time OP. I hope the advice on this thread will help you get more out of your medical consultations and get the result you want

GOOD LUCK OP, you’ve really been through the mill. You sound awesome x