to wonder why consultants comment on people's personalities?

[EverythingYouDoIsaBalloon]

Not a TAAT but I just read a post on a different thread that mentioned someone experiencing this, and it reminded me that I've heard about it several times over the past couple of years.

In 2023 I fractured my shoulder and as it wasn't a straightforward fracture I was referred to a consultant, who wrote in one of this reports that I was a 'very pleasant lady'. While that was nice to read, it baffled me a little as I didn't see the relevance.

Then a friend of DH's said a consultant had referred to him as a 'pleasant gentleman'. (Different part of the country, no chance it was the same person.)

Then another friend said she'd been referred to as a 'lovely lady' when seen for stomach problems.

Don't get me wrong, compliments are always nice. I just find it a bit strange in a health context. 🤔 I've wondered whether it's some sort of code for 'cooperative patient' or something along those lines, but then I can be a bit of a cynic at times.

Has anyone else experienced this, or does anyone know why it's done?

It builds a picture for safeguarding purposes.

It deliberately highlights what a patient is like to deal with I think

I was described as'interesting' once, not sure if that meant medically or just odd!

Shit sandwich. The notes are full of 'broken' this and 'painful' that. Nice to have a little nice in there.

Plus, it's code for 'not dangerous or scary' which many patients are.

It's a nice way of saying you're not a dick of a patient really.

That is what I have read before. I am usually referred to as 'A pleasant lady'😁

It’s a shame you can’t write them up in your notes as ‘being rude and unhelpful’ should that be the case though… I don’t like that! Obviously if a patient is abusive then by all means have that ‘on record’ but to be recorded like that is a bit much.

Yes, you are exactly correct in your assumptions.

Remember blame culture is rife in medicine. I’m a nurse and my documentation is the same. When we write care plans there is a part for psychological/social where I will comment on the patients mood/demeanour. Be it good or bad. Kept professional of course, but if a patient is particularly horrific I will quote exactly what they have said to me.

These replies are interesting, as they're more or less confirming what I had been wondering about this. Now I'm wondering, though, doesn't that introduce a potential problem in so far as if nothing along these lines is written in the notes, anyone who's following up in the future might think 'Ah, my colleague didn't write that they were nice, so perhaps this person is a bit of an arse'? 😄

Funny yes as I took my son to the gp once, she made a comment about him being the youngest child?! and that he was hyper. Thanks but I'm coming here as he has a urine infection and not for a personality test! (obviously I wasn't brave enough to say it but wish I was!)

My youngest has been referred to as fiesty since birth 😂 now every so often on her medical reports it will say things like awake/sleepy, happily interacting etc. Sometimes it will also say clean, well dressed or messy with eating. So I think part of it is safe guarding as well.

Those people tend to be quoted. "Patient adv. me that aliens had his brain and were eating it." Patient called staff member a "vicious arsehole" after being offered a meal.

That kind of thing. Having had to read out some delightful phrases in Court (after apologising to the person presiding) you'd be stunned what people say.

My oncologist described me as “very clued in” in a letter to another oncologist and a colorectal surgeon.

Hah! That's definitely code for 'don't try to bullshit her'

Comments on someone’s personality are unnecessary and judgemental. Unfortunately, this way of looking down on people is very much a feature of how some doctors act. It will become a thing of the past, as new training methods drag the medical profession out of its traditional way of thinking and behaving.

It's so that your health record gives an indication to future readers of what they're likely to expect from you. "Pleasant" is code for "normal person, not aggressive/rude/racist". Clearly they can't write "awful human being, avoid dealing with this person at all costs" on a record even if it's a fair comment. So they write nice things about average people, the ommission of such a comment being a warning to others.

Once I had "arrived in smart-casual dress" written about me, don't really know what relevance that had though or what it would tell a future reader. Guess it means they don't have to plan for the place to be de-loused after a future appointment maybe.

I write reports (physio) and I have never done this. It's really outdated and unhelpful. Someone could be having a bad day/acting nice then being an abusive arse outside the office.

I used to read 'pleasantly confused' on dementia patients notes. Awful.

We have very strict standards ( HCPC) to adhere to so we can only write fact.

What we can write might be 'patient appeared anxious about the diagnosis and became upset when discussing treatment options'. This is more helpful to receive than some weird character profile.

It's just a standard phrase which some consultants will use for everyone.

Unfortunately if you see me in clinic, I don't write at all after our team received a lot of letters about a 'delightful' gentleman who was busy telling us all to fuck off. Or the 'very pleasant' patient we are all in hiding from as he is so insanely demanding.

It isn't a doctor to doctor code, just a standard opening phrase for a letter. It does make my DM very happy though that she is pleasant, delightful or best very pleasant.

Hmm... I've just been sitting here thinking about this and wondering how I would have been written up if I happened to have stepped out of whatever the consultant considered 'nice' behaviour for a woman. For example, if I was having to push for information because it wasn't being given and they thought I was questioning their judgement, or if I disagreed with something that was being said, or simply corrected a misunderstanding. Some clinicians can be very prickly about this kind of thing. Would I still be considered 'lovely' in the eyes of someone like that if I disagreed with them, I wonder? I bet there's a gendered aspect to this too; we all know women are far more often perceived as 'lovely' when they smile sweetly and nod along, than when they question or disagree.

Don't get me wrong, I understand the logic, but I do think it's potentially problematic given the levels of subjectivity involved.

They're covertly communicating what you're like to deal with.

My cancer surgeon referred to me as 'a well read individual who has done a lot of her own research' when he was referring me for a 2nd opinion.

I thoroughly pissed him off in my initial consultation by challenging some of the stuff he said. He made this clear with some sarcastic undertones in the letter.

Turns out I was right to challenge it and the 2nd opinion backed me up.

It's definitely code. On my DDs letters she has been described as attending with her "very well informed mother who is very engaged in her care".

Which was definitely code for "this woman knows what she's talking about and is sick of the lack of action"

My then 16mo was described in a letter as 'certainly very lively and appeared well'

This was probably due to her bolting out of the consultation room wearing just a nappy and racing through the hospital with the consultant chasing after her.

I saw him recently and he remembers it very well, despite the passing years. Child is still very lively and looks destined to make a career out of it.

My heart sank when I read that letter though as knew it was code for something

Yikes. Definitely see why that kind of thing needs to be documented!

It’s completely standard lingo on all consultant letters. It’s not meant to offend you or be a judgmental on your personality. It’s helpful for other people reading your notes and helps to build a complete picture.

As a PP said, the default is to be described as “pleasant” lady/gentleman.

Of all the things to get wound up about, I think you can give this one a miss.

I dread to think what they thought about my appearance when I had my arm in a sling and personal care was about ten times harder than usual. 😄No, I'm being slightly tongue-in-cheek there, I'm sure they're used to seeing people not looking all that smart while their mobility is impaired. I'd have been intrigued by the smart-casual comment, though.