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?

The short answer to this is no. 🤣How dare someone with a vagina question my authority. Even female consultants can be like this. The medical profession is full of misogyny and everyone knows it.

I type these letters and it’s all very normal and habit! I wouldn’t read in to it! If you were very unpleasant, you’d just be a ‘lady’ or in my consultants case ‘woman’ as he doesn’t like the term lady! They save the rude comments about you in the comments specially for us admin staff!!

I've seen it used in education to describe parents.

I am guessing it means you were unpleasant. Damned by omission. Due to data protection (i.e. you can ask to see your records), they don't want to say anything outright negative.

I could be wrong and the person recording forgot to include the word pleasant or charming or delightful.

DH was once referred to as "a very charming gentleman who was mobile without a stick" by his oncologist. We laughed our heads off when we read it. He was 65 at the time, extremely lively and most affronted that this would be aging rock star could ever have been described like that. He's knocking 80 now and thankfully still just as mobile without a stick. DD4, a doctor, assures me that there are numerous mnemonics they use when clerking patients and they're not just referring to medical matters either!

I have a family member who used to practice medicine in Norfolk and back in the day (70s, 80s) they used to write NFN on some patients notes (Normal For Norfolk), which meant rather odd!

I hadn't thought about this (the whys/wherefores) but I recall my daughter being described as a 'big healthy girl' (she wasn't chubby! Just quite tall) when she was a toddler (and holding her poo). When she was a bit older, and referred for suspected still's murmur, her letter described her as 'pink and very healthy looking'. I had no idea that these comments could be code for her being well looked after 😂

When I was a teenager, I had to see a consultant about something and he said "So, on the letter from your GP it says 'ItGhoul is a pleasant 14-year-old suffering from - ' Wait, a pleasant 14-year-old? I've never met one of those before." 😂

I'd just like to add not all consultants do this. It is pretty outdated. On my team I would say most of the younger consultants don't do it. Some of the clinic letters I type are purely factual and don't include any opinions at all.

As a hospital consultant of many years, I do not write things like pleasant lady or gentleman. It is very old school and I am surprised that doctors still do this. I might comment that somebody has a good understanding of their illness or treatment plan, but that is that.

I see no need to make a subjective assessment of their personality. In the recent past, doctors used to write quite rude stuff in patients’ notes; that is unacceptable. And I find stuff like ‘pleasant gentlemen’, ‘charming lady’ etc somewhat patronising.

Is this going out of favour or have I got increasingly less pleasant with age I wonder?

I have been to a few appts in recent years and finding with particularly younger doctors they now just say 'lady' or 'you' as in 'You felt pain etc.." maybe this is a more modern way of writing. Hopefully!

I hope so!

Oh that's good to hear.

It just means the letter writer isn't using the pleasant/delightful letter intro.

It really doesn't mean more than that.

Pleasant/delightful are slowly being phased out and younger clinicians are less likely to use them.

I worked with a consultant when I was training who told us that ‘man or woman is a descriptor, lady or gentlemen is a diagnosis’…

Reminded by the NfN post, Normal for Norfolk, my medical cousin assures me that in Bedfordshire it's NfB, Normal for Biggleswade, and here in Devon it's NfT, Normal for Tiverton. I couldn't possibly comment!

@DollydaydreamTheThird and @WhenDoWeFly that's good to know, so it's not some kind of secret code then? So many people I know think it is!

I'd also add that when appearance is mentioned, some people like myself are very good at masking when in a bad way mentally and physically. I worry so much about being judged and what people think of me, that I always force myself to look the opposite of unkempt and to smile and be "pleasant" even when I'm feeling like I can't cope inside. I've had it conditioned into me as my dm always said "they'll think you're a malingerer others and won't take you seriously!"

*otherwise not other

Agree with this. You can't write someone is a shit head, but if you put what they said in quotes its fine.

It might be useful to track personality and presentation over time. So someone going from "charming and engaging" to "challenging, suspicious and malodorous" would indicate a problem.

Have any of the outraged PPs considered these comments might be in the your/patients' interests for diagnostic purposes when care is inevitably fragmented and many patients don't have family who attend appointments. Take a patient who is rude, aggressive, unpleasant, racist and the opposite of articulate, It can be diagnostically useful if their notes show they were previously always 'articulate and lovely', compared with always rude, aggressive, unpleasant, ....

In some of my reports it mentions that I'm a biochemist. I presume that's pre warning other colleagues to be prepared for my questions!

I think this means 'knows how to google' 😀

It just means you were a good patient.

Ha me too! They must have a default copy and paste template for it