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!

I trained a long time ago when consultation skillls were focused on. I was taught “ the golden minute” This means you don’t interrupt the patient for 60 seconds and listen intently.

It has been shown that the majority of healthcare professionals interrupt at less than 20 seconds.

Excuse me?
I wasn't criticising her. I was explaining I too do the same thing.

Yes you can. It is not only an expectation, under the GMC's Good Medical Practice guidelines, doctors have to take all reasonable steps to understand their patient's medical history, which should include reading the notes as the obvious step. Even the the most conscientious patient may forget to mention important drugs they are taking or forget their names, some symptoms etc.

I’m a dentist. There’s no way I would not have a read at a patient’s notes before they come into my surgery.
our system allows very important, pertinent medical information to be highlighted in an alert box as soon as you open the notes.
it’s highlighted in red “kidney transplant 2015” “pt on bisphosphonates” “allergy to latex”

I am
unfamiliar with the set up of medical notes but surely you have a similar facility to identify the alerts immediately without having to read through War and Peace to get to the important part?

This is what I was wondering. Surely there's a way the notes flag the most important history first?

She would have said during the consultation if she was allowed to talk. But he kept cutting her.
Let the patient talk and tell you what is wrong with them. He was extremely patronising to her from the very very start of the consultation.

I am a hospital consultant and want you to complain. He was a patronising dick.

I always read through patients’ notes before. When they come, I always start, after introductions (so important) and pleasantries, with a variation of , ‘this is the info I have read in the notes. I will just summarise it, as I know it can be tedious to have to repeat to to every new doctor you meet. But please tell me if I have it wrong as mistakes can happen in notes’. I then always finish by asking if they have said all they need to, have I missed something important and have they got the outcome they hoped for. It leads to a much more satisfactory end result for both of us.

I despite arrogant doctors like the one in the OP.

Sorry to hear that you ended up in A & E due to this awful GP . I have been on the receiving end of so much patronising, misogynistic crap from various health care professionals over the past year trying to advocate for my daughter and it’s so demoralising. For me there seemed to be a lot of point scoring ,dismissal of information I was providing which later turned out to be important and a general attitude of ‘ what could you possibly know about it ‘ , quite a lot as it turned out.!
Well done for speaking up, hope you get better soon and get that complaint winging in .💐

I am a little frustrated at all the comments saying the GP wouldn’t have time to read through all my notes and how crap the IT system is.

I agree, having seen how difficult the NHS app is to navigate

BUT there is a triage online system in place where you request the appointment and it has 2 key fields: what is the problem? And what is your expectation? I have blacked out any personal details but here is a copy of mine for my appt yesterday .

Surely…SURELY the GP has 20 seconds to at least glance at this, no?

I’ve had two surgeries for large ones, one of them didn’t feel anything. The other was solid but ruptured, felt like I was giving birth 😂

He was a massive twat though, he also used to say autism does not exist and is caused by lousy parenting. 😳

Last thing I heard was he was training to be an orthopaedics surgeon. Wouldn't trust the fucker with a scalpel. 😂

Yes he definitely should have looked at that and got the gist of it.

Absolutely complain. Email the practice manager and head your email "Formal Complaint". I had trouble once with the surgery and did exactly this, they got back to me within the hour to try and rectify the situation (more of an admin thing in my case, but still I had been patronised and talked down to and the person I spoke to just wasn't listening to me.) Good luck!

But I clearly said I do read my patient's notes and that it was poor that the doctor hadn't picked up on this. However I've lost count of the amount of times I bring a patient in and actually ask what I can do for them and give them time to talk and they reply 'well you should know already from my notes' or 'I explained all this to the A and E doctor 3 years ago I'm not going to repeat myself' I think there has to be a degree of realism. GP notes sometimes contain 20 years worth of consultations and letters....

Tbf I also get patients that do this the other way round, don’t let me actually finish a sentence. Some people are just knobs and like the sound of their own voice. Get it everywhere not just in healthcare.

YANBU and you are a legend.

I'm a GP

You weren't unreasonable in this scenario at all, you should have been listened to and sounds like his communication skills left a lot to be desired! He should have read the notes relating to the appointment ahead of time.

However. Having appointments lasting 10 minutes per patient - including reading notes beforehand, recording the consultation after etc is a nightmare and does make it impossible to fully read notes. I hate it. But that's the way it is - see 18 patients in 3 hours, 10 minutes break to allow for a quick wee and then onto home visits. Awful but not always the GP's fault.

Also on most GP systems you can put alerts onto the computer system so it flags important information. When you complain maybe ask if they can look at how the transplant info is recorded.

Hope you feel better soon.

In A and E you can ask where you are on the waiting list. And if they have not put you as a high priority you can argue and say considering you are at risk of kidney transplant failure you need to be seen quickly.

For GP's, we are very very lucky. Ours is amazing. Always thorough and we can always get a same day appointment without any fuss. Even calling at 3pm if its important they will see you. Had one doctor stay behind to make sure they saw my daughter once when we called late. If its a routine appointment needed they go through the calander to find a date and time that works best for you.

You are right on those circumstances, with not so cooperative patients, but this is a completely different situation to the OP. The OP case involves an arrogantvpatronising GP putting her life in danger if she had not spoken up for herself. He was arrogant, patronising and negligent. And, sadly, not the only case going around.

Yes, I’m afraid the people saying the doctors don’t have time to read notes didn’t bother to read your posts either. It was obvious from your op you’d have mentioned your ‘conditions’ in the triage form. And absolutely the dr should have read them- could have done so in the time it took you to cross the room and sit down I’d have thought.

hope you’re getting the treatment you need now

Just reading this made me feel furious. What a patronising fool!!!!

well done for giving him short shrift. Hopefully he will reflect on his attitude ….

I think many patients think we have a centralised NHS notes system that allows us access to whatever input they have had from wherever in the country. Whereas where I work we only have access to notes from our Trust. I don’t blame patients for not knowing that.

I get the ‘however’ but have you read my latest update?? Would you consider this unreasonable to expect a GP ti have read this?

YANBU, and yes, you should complain.

My Dad was told his pain was shoulder tendonitis. He thanked the Doctor and told him he was relieved, because his last scans showed bone cancer there, but tendonitis was much less concerning. He then left and asked for a different doctor.

It BAFFLES me that GPs don’t read the notes before taking in their Px. I couldn’t imagine not doing that in my job, I want as much info as possible before I call the Px through!!

Another doctor apparently incapable of listening. Never mind having to announce your transplant as the very first words out of your mouth, he needs to give you a chance to explain your situation before trying to brush you off. What a knob!

I don’t think that. I understand that when I go to St Helier vs St George’s, despite being only a few miles from each other, the systems don’t talk and my doctors can’t see info from the other hospital

i DO expect them to read my fucking triage notes from their own Practise though