To have been patronising to the Doctor?

[LiveTellyPhrase]

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!

This

I’d lead with the transplant at the very start because the appointment sounds frustrating and annoying.

Really happy for you with your good outcome and comfort being a transplant recipient. This sounds like a way that works very well for you in appointments.
The person I know who received a kidney, though grateful, still has difficulty talking about it.
Also they defer to doctors and know that on screen, next to their name, will be info on allergies, taking immunosuppressents and being a transplant recipient. This information is highlighted. So they assume the Dr knows their name and the important information. They’d see it as rude to start with it - I’m NOT saying it’s rude as I think it can be helpful if it’s the type of GP who is open to being helped.
Obviously any hospital doctor is less likely to know anything about you so it needs to be on a flashing sign above the head, metaphorically.

This is often the difference between life and death. There is no point completing the notes if GP isn't going to read them. YANBU.

You were not unreasonable @LiveTellyPhrase. I hope you are feeling better.

Some Drs are absolute horrors.

My cracker, in the fracture clinic, pribably a junior Dr. I had a badly broken, plated wrist and in the same fall had wedged a vertebrae. The cocodamol wasn't touching the back pain, the naproxen was but I had googled and read that naproxen could impact bone union. He said:

"Get your head out of the internet, it's full of nutters". He didn't answer my question. He was a rude git from the moment I stepped into the room.

I'd seriously put in a feedback form or complaint about that doctor - that's so basic and a less confident transplant patient (or someone who reasonably assumed he did know they have a transplant) could have been sent away untreated.

I'm a doctor and usually think most mumsnet complaints about doctors to be a bit unreasonable, but you are most definitely NOT being unreasonable and he was incompetent!

I'm just massively proud of you for standing up to him. So fed up of these kind of shitty attitudes I really am, but it's made so much worse by him trying to make YOU the reason communication failed. What a dick!

I had similar from a nurse once. I'm asthmatic, but grew up with a mother who treated everyone else's minor ailments as something much worse than my asthma and was depressed, so.didnt keep on top.of my medication.

Went for my flu jab. Was kept waiting half an hour, then spent 20 minutes with the nurse. She concluded that my asthma was minor since I hadn't got a prescription for months and I was, and had been, wasting NHS money for years. She read through the list of those eligible and pointed out I wasn't on it. I remarked I'd go speak to the doctor and she went through the list again, telling me he'd say the same thing. She was awful in her manner and I left in tears.

A week later the receptionist asked if I'd had my jab and I told her what happened. She was horrified. She spoke to the doctor then made an appointment for me with him at a time she was working so she could back me up if necessary. I got thr jab with a request to get an asthma review.

It was the same woman. I lied and told her we'd never met. She upped my medication from what it had been and made me promise I'd take it. I wish I'd said something about our previous encounter on the way out.

I asked the next year if I'd have the same problem only to be told she'd been asked to leave her job. No surprise, really.

He was being completely unreasonable - maybe it wasn’t obvious on his screen that you’d had a kidney transplant, but if he’d let you talk, you would have been able to explain. I think your reasoning for wanting to complain - that others might not have the agency not to be fobbed off by his attitude and demeanour- is sound, and his position he ought to realise that sometimes what people don’t say is as important as what they do say, and focus on listening as much as broadcasting. The ‘dear’ was a particularly patronising touch.

I hope werent in a&e for too long and wishing you a speedy recovery 💐

You are absolutely right OP and well done for standing up for yourself. I once had to shout (something I rarely do!) at a doctor to give me antibiotics - the last time I had been fobbed off without them, I was hospitalised with sepsis.

Guess what? The doctor hadn't read the notes and seemed embarrassed I had pulled them up on it. I was handed a prescription fairly swiftly after that!

I think you should start by mentioning the transplant. You can’t expect a doctor to read your notes very quickly.

Exactly. If you don't want to listen to the patient's 'waffle', read the notes. If you don't want to read the notes, listen to the patient. You can't have it both ways!!

It would've been the bububub that would have made me want to punch him in the face. You handled it beautifully. I work with a wonderful medical consultant who had to have very firm words with a GP after the way he spoke to one of my Nurse colleagues last week - needless to say he listened to the Consultant but not the Nurse.

She didn't expect him to as she has pointed out.

Oh my sweet summer child 🤣 You think with the state the NHS is in any doctor feels like God?!

Thank you all for your comments. Well, I’ve spent 6 hours in A&E having been triaged pretty quickly. Managed to sleep a little bit on a chair learning my head on a vending machine!

It looks like it has travelled to my kidney so they are now liaising with the renal team here to see how to approach it.

I absolutely will be following this up and I’m so sorry to read others have had similar experiences

Just to share not every GP is like this. I went to see a new, to me, GP. I'd had the UTI from hell (lasted 4 weeks) followed by thrush, followed by being sore around my nether regions.

She has been at the surgery a while but it was the first time I saw her, while she was examining me she said something about my skin, I said I have psoriasis and she said, "yes I read that in your notes".

My notes are like war and peace in size so I was quite impressed.

When you have a few conditions it's not always easy to remember them. I had an abdominal and pelvic ultrasound last week, and as the sonographer started I remembered I've had an ovary removed, because I had been telling her the symptoms of the latest health problem I totally forgot about it.

Well done OP. I have MS and I could’ve been diagnosed and given treatment years earlier than I was if I hadn’t been fobbed off by so many doctors telling me I was overreacting. I really wish I’d pushed back more but I was taken aback by the way I was spoken to and almost laughed at. Now it’s a routine experience for me to turn up to an appointment and have to tell them I’ve got MS because nobody has ever read the notes. It really scares me thinking about the people who wouldn’t be able to speak up or advocate for themselves in a similar situation.

I had an enormous ovarian cyst and felt nothing lol 😂 … but he does sound like an arse!

He was incredibly rude and should never act like that but GPs don’t have absolutely no time to read notes before each patient. It sounds like you submitted an e consult before - I would have definitely included that key information there

Thanks for doing so. It, hopefully, will encourage this arrogant idiot to LISTEN to his patients, instead of "let me stop you there...."
Also, to read the flipping patient's file!!!! How difficult can it be? And if you did not have the time, then ask: did you have this before? Any other conditions that may be related to this?

I always start with “I have a weakened immune system due to being born with an extremely rare congenital heart condition. I am the only person to have had my surgery and survived this long. So can we please discuss X, in relation to my immune system”
unless I’m talking periods.

She did do that I think. She mentioned about pre-existing conditions on the form anyway. It says in the OP.

I'm a doctor and yes in OP's case I would have expected the doctor to read enough of my notes enough to know that I'd had a kidney transplant. However I despise being patronisingly told by a patient that I should read the notes. I have 10 minutes per appointment before the next patient is getting annoyed I'm running late. I might already be running late because somebody needed emergency admission organising, or I saw a complicated patient. Yes I will look at what I think is relevant before I start the consultation but I simply don't have time to look through years worth of notes and it honestly comes across as quite self important to expect me to. I get that it is annoying to have to repeat your medical history but if it's relevant and you're not sure the doctor is aware of it then it's probably safest and easier for all just to mention it.

I had my ovaries removed when I was very young and have an underlying condition that makes childbaring very unlikely even if I hadn't. I still get frequently asked if I might be pregnant. No big deal. It's a standard question coming from a busy nurse/doctor/other who has many more people to treat that day than me.

OP I'm not saying any if this to say that how your consultation went was right btw. I agree it sounds like it was poor. I'm just giving the other side's perspective.

I can belive this all too well. Systems are rarely patient/learner/person centred but instaed designed around business need, or worst of all, what worked for the system designer. This is why UX (user expereince) is a profession, not used enough.