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?

This is standard unless you’re arguing with the medical staff and then it says you were “anxious” or if you’ve had an agonising procedure it says “I believe Mrs Smith found the procedure somewhat uncomfortable”

The consultant rheumatologist didn't comment on my appearance but the GP letter said "It was a pleasure to see Ms Trailmx again"

Which was a surprise to me as he didn't look at all pleased. His expression said "Oh god not another one complaining about aches and pains".

Perhaps the clerical staff just use their imagination when typing the letters?

I'm usually "a pleasant lady" and I don't really like it, though can't articulate why.

At a recent appointment the nurse asked me to fill out a survey about the consultant after I'd seen him. There were about 25 questions including things like "did he ask about your life?" and "did he seem interested in you as a person?" and I thought poor sods, not only have they got to do their jobs but they need to make actual small talk as well. I'm guessing this is all some part of an NHS initiative to make care more personable or something.

"Very pleasant" = clean, coherent, not intoxicated, hasn't tried to assault any of us.

It's so common it's not worth noting. From a bygone age!

It's doctor code for "normal/not an arsehole".

Has there been outrage or has there been curiousity and gentle discussion?

@ivyy I'm learning the hard way that we need to unmask ourselves. Big thanks go to our mothers for teaching us to be good compliant little girls 👏I've just been through hell with surgery that if they had diagnosed me correctly would have been done and dusted a year or more ago. I was gaslighted so much. I was telling them how painful it was and they diagnosed me with a much less serious and less painful condition. Finally get the surgery. Then I had postop complications and pain worse than before the surgery. I just thought what merry hell is this? And again I had to push all the time to get rescanned, hours waiting in A&E in absolute agony. Guess what I was right, funnily enough I know what pain feels like and I am going to have another procedure. I am so frustrated by the way I've been treated. Unmask we have to do it. I've become a good advocate for myself in the last two years.

I think it is outdated. I write referrals and NEVER comment on personality. I might say - the patient who is anxious about X, or who has researched Y - but not subjective nonsense. If I m writing a referral because it has been demanded of me and i think referral will probably bounce, I might say 'I am referring at the request of patient'. So yes, there is a bit of code, but I do think I see much less 'pleasant' and 'lovely' coming back on clinic letters too than previously. As you say OP, it is irrelevant.

I agree.

My Oncologist in clinic notes and letters never makes any comment on my personality or my gender. The letters are factual with headings: Diagnosis, Clinical review, Investigation update, Management.

I am referred by my first name and there might be an observation, e.g. I saw Twointhemorning with her husband, or Twointhemorning attended clinic with her husband.

I was once called a "very pleasant, married lady" when being referred to the EPU 🙄. The GP who referred me was very Catholic going by her adornments (crucifix necklace and rosary bead bracelet) so I imagine approved. She was a locum so I didn't complain but I wish I had.

Mm, interesting. I asked lots of questions so I probably annoyed her!

My most recent fave is 'this pleasant married mother of two'....

It was a gynae.

How my marital status was relevant i'll never know 😁

Fellow med sec here. Yes they don’t hold back with the admin staff 😆

I was reading my NHS notes yesterday and I was surprised by how much it says in consultations of what I said. How do they get all of it ? They don't record you do they?? Is it just all the typing as you are talking?

I suspect the “small talk” gives them a lot of insight into the patient that they wouldn’t necessarily get otherwise - social factors that impact on wellbeing can have a big impact on outcomes, and the chit-chat often tells you more about a person that a formal interview. People aren’t necessarily always 100% honest with doctors - they might tick the box that says they can manage their aftercare but it can come out during chat that they have stuff going on that might mean they struggle.

I was described as a "very good looking and extremely intelligent young lady" by my neurologist in his letter when he diagnosed my movement disorder! Either he was being overly nice to soften the blow of diagnosis, or he was just quite smarmy lol 😆

I was once, unbeknown to me, referred to as "an NHS Director" in a referral letter to a Consultant.
Cue, much confusion in the consultation when she asked me which Directorate I was responsible for.
I worked for NHS Direct.

Your consultant must be a dictaphone mumbler. 😂

I don't write clinic letters anymore but when I trained, it was just a common way of starting a letter. Everyone was a pleasant man or woman. Obviously, falling out of fashion now but certainly not meant as a true reflection of someone's personality or even an opinion, just a standard phrase. More recently, letters just said you came, what happened and when you were coming back. Short and factual.

I don't type as you talk but am pretty good at remembering what was said.

Am sure you have similar skills in your job that come easily to you but are a mystery to others.

I'm a consultant. It used to be taught as a very standard way of writing clinic letters to open with a descriptor of the pt as pleasant/lovely/charming/delightful similar, and the absence of such a descriptor meant the patient was difficult/unpleasant. I always smile a little inside when I hear people say proudly "he said I was a lovely lady" when I know that it's the start of everyone's letter.

I suspect there is also a little bit of wanting the patient to feel well disposed towards the doctor, so less likely to make a complaint.

I choose not to use it, as I think it's either used as a judgemental description by it's presence or absence, or it's a completely meaningless thing because they say it to everyone. I like a compliment as much as most, but only if it's actually meant.

That's shocking (the good looking bit ). I would be speaking to a colleague if I saw they had written that in a letter.

I have been described as "pleasant" on several communications, I think it is shorthand for reasonable and not likely to kick off! Years ago when I was under the care of the local mental health team I saw that I had been described as "charming and attractive", this was back in the early 90's, doubt they would do this now

There really is no need to mask this way so please don’t feel like you have to.

And I have never used those silly mnemonics and codes when writing or speaking to colleagues. I don’t believe anyone does? I see them as urban myths perpetuated by immature students at medical school. Consultants should not be behaving like this.

Really, doctors are not as special as many think they are. They are trained professionals doing the job that they are paid to do. You don’t need to dress up for them at all.