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!

Agreed.

Well done, what a patronising GP and so glad you stood up for yourself, a lot of people don't because they presume GP is always right.

And.. a good GP allows the patient to speak. Hope feeling better?

PS- I have two serious illnesses misdiagnosed/swept under the carpet by GPs. Don't trust them, I always question now.

To be honest I see both sides of this. I totally see how you felt patronised but I also can see how he didn’t have the pertinent info. I think communication could have been improved on both sides.

Yes, I agree with you that he should have read your notes and not been rude. But my totally logical/pragmatic side would have led me to lead with the most serious information ie as soon as I booked the appointment or sat down, say “I have had a kidney transplant and have been advised to seek urgent help if I have signs of a UTI”. Then let them lead the next steps. I don’t think his comments were great if you didn’t have a kidney transplant either, I’m not excusing that - but I am aware that NHS GPs are overwhelmed, likely don’t have a lot of time between patients to thoroughly evaluate notes (especially if the relevant notes are far down your file) etc.

Generally speaking I’ve always been able to get GPs to do what I want and I achieve that by speaking their language so to speak, understanding their limitations and adjusting my communication to that. I’ve never had an issue getting the prescriptions or referrals I want as a result and I have regularly been on the receiving end of patronising GPs - hence this learned approach

I would have lost it at the ‘bubububub’. What an absolute prick.

Please read the full thread. The information was not ‘buried’

Still in A&E waiting for a bed to become available

And getting increasingly frustrated with all the posts saying ‘yes..,BUT…..’. None of the ‘Buts’ are relevant to my situation or consultation. None of them.

Sure, but another GP has already responded to
you to explain how little time they have between patients and you seem to have disregarded that. A little understanding on both sides doesn’t hurt, you don’t need to be defensive at any perceived slight

This may sound odd but Co Pilot put together a very good shortened version of events with my conditions. I simply read that out to the doctor while they listen.

Are you sure he could see your triage notes?
You would hope so but it’s quite possible that they are on different systems. Where I work it’s practically unreadable, and I ask people why they are here. Sometimes they don’t even know themselves. I wouldn’t be a GP it is thankless. That may not be the case and not for you to sort out, but it’s so pants atm as NHS is on its knees.

Never seen or heard of an online triage form.

You were right, there's a bit if a subservient mystique around how people treat doctors and yes they should be respected for their expertise, but they're human beings and some are better at their job than others. The ones not fulfilling the criteria should be challenged, patients must advocate for themselves as you did.

I can't believe this apology for unprofessional rudenes and blatant misogyny. Why should the OP assume that a professional HCP is going to cut her off with a hand in the face after 5 words? I think you were very restrained OP.

Just back to this for a moment - the OP obviously required treating according to her consultant’s instructions via the GP. And I do understand the issue of overprescription and AB resistance.
But when I got a UTI on Xmas eve last year I was glad the pharmacy could prescribe this one which concentrates in the bladder so presumably isn’t quite such an issue as systemic broad spectrum ABs?
https://www.nhs.uk/medicines/nitrofurantoin/about-nitrofurantoin/

the op mentioned it in her OP and then expanded on what she’d written in a subsequent post. Afaik they’re quite common now - the fact you’ve not encountered one personally is somewhat irrelevant.

I'm sorry to hear your condition has worsened and hope you're on the mend soon. The notes thing may be moot but if you're not going to read the notes OR allow a patient to speak then you're a dangerous as well as a prick.

Makes it hard for me to assess the situation but anywho you carry on.

YADNBU BUT
Don’t complain, their time is better spent on far more important medical issues.
You made your point very well. Well done.

Yes, they responded, as you did, that doctors don’t have time to read through notes, especially for conditions with years of history as they only have 10 minutes per patient.

i am not dismissing that. You are dismissing my response which said that I gave a summary AND even what needed prescribing in the appointment notes. In the time I walked in the door and sat down, he could have read those few sentences but chose not to. It did not require looking through buried notes, it was there in front of him as it has been for many other appointments at that surgery with other doctors.

Im glad you have found the right way of expressing your condition and ‘learning the language’ but I expected my GP to have at least glanced at my appt notes and not interrupt me 5 words into my first sentence

No, you would not have been told she was asked to leave her job. That is confidential employer / employee information.

You're making it up.

Had recurrent UTIs for years.Like you Op I know how they feel and when they are starting because I've had so many. I was very ill several times as a young woman , when the infection travelled to my kidneys, because I didn't have the confidence to advocate for myself until it got really bad. I went to see the doctor once ( he was later struck off for having child porn on his home computer . Nice) He was sitting in the dark so , when he dipped the stick thing, he couldn't clearly see the blood indicator and announced that I didn't have cystitis. I knew I absolutely did and suggested he put the light on. " Oh yes, blood" he said. Wanker.

Yes, this is useful info to know and you CAN get treated by a pharmacist I believe. Unfortunately I have developed lots of resistants to various antibiotics and with severe kidney disease I also have to be careful so I will always have to be seen by a doctor to get the right ones

You've never been on the professional side of itthough, have you.
I ve said I was a solicitor up thread. I've had clients go round the houses ten times before they answer what I need to know.

No, I don't really need to know all of this background information.First, just tell me the issue I want to know.

She knows she had a kidney transplant.She knows how bad it gets. In a short appointment, sometimes there isn't time to read the records.Just tell him. I have a transplant, would be the first words out of my mouth.If I d had one.

Not I ve had some urinary urgency.

Sorry somebody didn't sit back and allow her to monologue until she got to the point, sometimes there isn't time for that.

Haha you made this idiot look really stupid....good. My GP is equally dismissive. I really hope he felt a proper chump.
A lot of my own patients have been spoken to in the same way.

I'm a solicitor too. Day 1 of training is how to interview a client. And cutting them off after 5 words with a hand and bubububub is not it

I agree with other posters that you should have a script, but (a) I'm not sure you'd have got very far into it with this doctor before being interrupted and (b) the only reason I think you should have one is that doctors sadly don't tend to know their patients the way they did when I was little and "family GPs" was a real thing, and they have not always read your notes. I don't think you should have to advertise something crucial that is clearly in your notes if they are read and I share your frustration that so much of your and his time was wasted because he wouldn't let you speak.