To have been patronising to the Doctor?

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Sorry, I’ve just read this and it’s long but was very cathartic to write out!!

I have a kidney transplant. I’ve had it for nearly 10 years and was diagnosed with kidney failure after contracting an auto immune disease.

Ive therefore had a LOT of contact with various HCPs over this timeframe and am often taken aback by inappropriate/uneducated comments about it (one RENAL nurse once asked me if my kidneys failed because I ‘ate too much salty foods’ 🙄 .

I was given an emergency appointment this afternoon as I have a painful UTI. I don’t wait to see how these progress but always see GP at first sign as they have travelled to my transplanted kidney before.

Before The appointment I filled in all the online admin about why I was there, what I needed, if I had any conditions etc.

When I went in to see the doctor I started to explain that I’d had some urgency around the toilet. Before I could go any further he interrupted with a ‘let me stop you there…’ and asked me if I was dehydrated, did I do pelvic floor post birth, asked why I had jumped to conclusions that it was a UTI…

I started talking again and explained that I had many before, the feeling was the same … I noticed he wasn’t listening at this point and was looking at his phone. He interrupted again and said he was reluctant to prescribe anything and UTIs can build tolerances…I started to then interrupt him but he put up his hand and went ‘bubububub’ to stop me talking.

He said did I have any pain? I said yes, I was concerned as the pain had travelled up to my kidney and pointed to my pelvis.

He immediately looked very smug and said ‘dear, your kidneys are around your back… i think if the pain is there it may just be your period, or perhaps you pulled a muscle’? He started to stand up and talked about coming back in a week if it hadn’t improved.

At this point I interrupted again and said, in an equally patronising tone ‘dear, you’re right, my non working native kidneys ARE on my back, but my transplanted kidney is at the front and I’m pretty sure I’m at very high risk of hospitalisation if it travels there, which it very much can do as my unrinary tract is shortened’

He spluttered at this point and very abruptly pulled me up for not having mentioned my transplant. I said ‘if you’d have let me finish any one of my sentences or reviewed my notes, you would know this’.

He did end up writing a prescription but tried to have the last word by saying as I walked out ‘next time please do make it very clear you have a transplant’. To which I told him next time to please read the patients notes.

Honestly I’m so sick of being talked over, told what problems might be or even someone trying to tell me (again, GP!!) that I now only had one kidney as I’d had a transplant!!

I despair for anyone who isn’t very well versed in their own conditions and has to navigate these situations and take the word of doctors as gospel!

So AIBU to have replied patronisingly (I NEVER do this and am not quite as quick to quip back as I was today) and should I complain to the practise manager? I don’t know if it’s just the straw that’s broken the camels back!!

and to add, I have some wonderful nurses and doctors on my teams who are amazing which I do recognise!

What a cheek! Bloody insult!

You are fantastic!!! You said the kind of thing that I wished I would have said in that situation but instead I would become meek and mild. Good on ya. Don’t doubt yourself!!

GP was rude and ineffective but always lead with the important stuff.
'I have a transplanted kidney and I'm concerned I have a UTI. '

In my case I start with, I'm quite deaf so please look at me when speaking, followed by I have Chronic kidney disease and /or eustachian tube disfunction depending on why I'm there.

Might seem direct but gets you to where you need to be faster.

YANBU with bells on OP! What’s the point of the online triage form if the doctor doesn’t have time to read them? This gives the patient the false impression that the GP knows the information. So they should do away with the online form so the patient is clear that the GP will need to be told the salient details. Also, the GP should not be interrupting and saying “Bububub”; how patronising!

Also, everyone should be aware of the new Jess’ Law, especially people who often get dismissed.

My father, attending an annual review and having been a diabetic on insulin for over 20 years was once asked by a doctor “what makes you think you have diabetes?” You really couldn’t make it up!

I am a consultant and I think you were exactly right. We should always listen properly to patients, and a great many people with chronic conditions will know far more about their own condition than a GP. Even a specialist like myself will know far less about that particular patient's own experiences and history than the patient (unless, maybe, they are someone you know very well and have been treating for a long time, in which case you will be collaborating on the care plan). The days of "the doctor is king" and patients must shut up and listen to their superiors are long gone, or should be, and it is sad that some doctors haven't got the memo.

And if he really called you "dear" I would have hit the roof if it was me! (That attitude also tells me that he would not have dismissed a male patient in that way).

Why wasn’t your opening line I have a kidney transplant. He was rude but you sound like desperately hard work and were very rude in return to someone just doing their job. How long do you think gp’s have for appointments- there is no time to waffle.

Ha, yes. DH (in his fifties) was recently told by a doctor that he wouldn't have Type I diabetes at his age, it would be Type 2. DH calmly pointed out that he hadn't just been diagnosed with it, he'd had it for 35 years.

To focus your complaint efforts into something more useful to you - it might be better to go down the

‘the fact I’ve had a transplant and need different approach to normal protocols seems to be being missed’ rather than GO didn’t read notes. Might be more constructive in the long run.

The GP will have almost certainly done the skim read, which probably said urgent appointment for UTI at patients request. Or words to that effect.

At which point they approach it as a standard UTI interaction (which numbers wise on what they are coming through the door) will be an unnecessary use of an appointment, by someone seeking antibiotics prematurely.

What you need from them is a solution that both flags that this isn’t the case for you, and is realistic for them on appointment time provision and notes reading.

If it’s gone to an in person appointment the person seeing you potentially won’t have read the full online request info. That’s used by the people who process those requests. It then goes into the appointment schedule with the one line header.

I don't blame him for not having read the notes - it is tricky to have time, fair enough. But rudely interrupting and being patronising about what's going on is 100% not acceptable, I would definitely raise it with the practice and suggest how it could have gone better. Ensuring doctor had access to the triage content you sent in, that he read it, that he gave you at least a couple of minutes to say in your own words what the issue was, that he adjusts his tone so it isn't patronising, that he asks you why you think it is a UTI etc. I was once diagnosed with a UTI, despite me insisting it wasn't having had them before, and ended up with sepsis due to an infected surgical wound 😥If they'd listened to what I was trying to say and WHY I thought it wasn't a UTI I probably wouldn't have ended up septic.

JFC I'm livid on your behalf. If the consultant who did your transplant had heard that conversation they'd have kicked that GP's arse up around his ears.

My GP dismissed my pain in hips again and again. I did have an x-ray which he said showed nothing. He did say I could take painkillers. I was on two sticks after two years. A physio tried his very best for me.

In despair I went private. As I walked into the consultant office and sat down he watched my gait. He asked some questions. Sent me downstairs for an x-ray. The result both hips stage four bone on bone. Right hip had migrated upwards. I needed surgery.

I was in shock and wept because finally someone believed me.

My consultant has written three very forthright letters to the GP copies of which I treasure.

Three months later I'm recovering from my first surgery, second surgery to follow in the next few months.

I'm so glad I pushed back and insisted on a referral when my surgery had written me off.

This

I now tell my mother in law to do the same
she lives on a county border, and is frequently sent to one of 3 hospitals in 2 different counties.
not only are they unable to correct her address, one she never registered at, and letters and appointments frequently sent to the wrong place, one Hopsital has no idea what the other has done. Plus she gets voicemails to say to call the GP or Hospital urgently, only to find they need to do another test. She has a heart condition and the stress isn’t helping.

Even different departments in the same hospital don't seem to communicate with each other, so across a county border doesn't surprise me at all.

Years ago I rang 101 out of hours at 2am as my 4 yo was in a lot of pain after a throat operation. The operator asked me if it was possible she was choking on a fishbone... wtf! My response was patronising too, to say the least!

Poor you! My lovely mum is in a similar position with her knees. Being dismissed and sent for physio again and again. Eventually she went private and paid for an mri which showed bone on bone on both knees. Apparently the x ray done on the nhs didnt show anything as she was lying down and it should have been done when she was standing. Very frustrating!

I hope you’re recovering ok and your second op goes well

Tell me you haven’t read the thread without telling me you haven’t read the thread…

Finally being discharged thank goodness with a follow up scheduled for next week.

Unfortunately being on a ward doesn’t afford you much sleep - lots of loud patients and being woken for observations through the night so I’m very much looking forward to my own bed tonight!!

Yes normal in gp now. They awful. Mine is 10000 times worse ..you be shocked but it's not worth complaining as there no one else... everyone complains between themselves and their reviews are rubbish but no one else...it's why our a&e is always at crisis point

Most surgeries now use system1 which has a section called “major problems” which should show op had a kidney transplant. So the doctor should have easily been able to see this without reading the notes she had already submitted herself which he clearly didn’t.

They don’t need to read the notes, there is a section on patients records that shows all major, minor or inactive problems. Having a kidney transplant would/should be on the major active section. It takes 2 seconds to have a quick look at this before the patient comes in or as the patients is giving their history and what their problem is.

Glad to hear you’re on the mend OP.

I have that on my phone in the notes app
condition
medication
which hospital/specialist/dept

everyone has always been appreciative of it (probably so they don’t have to try and spell half of it!)

Could agree more with this reply-
No you shouldn't feel any negative way about how you spoke to him, HE was rude, he is meant to be there to LISTEN, & care for your health & wellbeing- nobody knows your body the way you do & im so glad that you have such a great understanding of your situation & you were able to actually get what you needed despite his lack of empathy, respect & professionalism! Not sure if I would complain cos let's face it what will happen? Nothing I'm sure- but if it gets it of your chest & makes you feel better about it then absolutely go for it- your your own best advocate 🥰🥰