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!

But it was all in the online form OP completed before the appointment. The GP didn't have to read all the notes, he just had to spend a few seconds looking at the form, which would have save him several minutes during the appointment itself. What is the point in making people fill in the form if the doctor is going to ignore it?

You are not being unreasonable in the slightest. They can be nightmares, they deal with so many people who don’t know their arse from their elbow they think all patients are the same.

Well done for telling him, he sounds like an arse.

It is the only way to get an appointment at my practice.

Just because you have never seen or heard of something doesn’t mean it doesn’t exist.

Sorry you're unwell and I hope you are feeling better soon, but you seem to be implying its the GPs fault you are now in A&E? How could he have prevented that - you said he gave you the prescription you needed?!

UANBU, OP! When I was last ill, I was misdiagnosed three times after COVID and prescribed the wrong medication

I’ve taken to writing a list of my symptoms on my phone and plonking it on the desk for the Doctor now, every time I visit, to save them time though, as it seems to me that if they spend any time on the PC, the information isn’t easy to find.

If I were on any medication, I would also add this to the list, but at the moment I’m not taking anything long-term…

I’m a doctor and you are absolutely not being unreasonable. He was a twat

what did the GP even mean by ' ‘bubububub'?

I have to sympathise with you, OP.

I gave up after seeing the doctors after I had seen the first three neurologists about my medication induced neurological involuntary movement disorder called tardive dyskinesia.

They all gaslighted me and I was fed up with their condescending attitudes.

I diagnosed my movement disorder myself but only the fifth neurologist agreed with me. It's extremely frustrating and I do empathise. Doctors aren't the fountain of knowledge.

When I went in to see the doctor I explained I had received a kidney transplant 10 years ago, and started to explain that I’d had some urgency around the toilet.

I totally agree, make sure there is no chance of the vital information being missed.

Some of them do like to assume that you’re pretty stupid and Need Educating.

A dd was referred for having her tonsils out, and the consultant immediately began telling me that nowadays it’s really not recommended….
I stopped him with ‘Can I just point out that I have not asked for this, it’s my GP who thinks it’s necessary.’
To be fair, he took one look at DD’s tonsils and said, ‘Well, I have to agree.’

Re the God thing, though, a lot of older people certainly used to look on the Dr as God. My long-gone DM certainly did, mind you she died at 97 so I dare say most of that mindset-cohort will be gone now.

From my post ”Im now in A&E. This isn’t as a direct result from my appointment’

I have in fact said the opposite. It’s not due to my appointment. The point I was making is that if I’d have listened to his dismissal that it was either period pain or muscle cramp then I may not have brought myself to A&E where I’m in the process of being admitted

I am worried for your clients. I am client facing, data gathering - not a solicitor but professional equivalent. Your attitude is concerning.

That may be the finest piece of victim-blaming I've ever encountered. Congratulations.

How dare the OP seek to use more than her allotted five words, honestly. I bet she said, "Hello" too; wasteful!

Perfectly played. Well done you.

"Nitrofurantoin is often described as a broad-spectrum antibiotic because it is effective against a wide range of both Gram-positive and Gram-negative bacteria that cause urinary tract infections (UTIs). However, it is effectively used as a narrow-spectrum agent in practice because its therapeutic use is restricted to the lower urinary tract due to its unique pharmacokinetic properties."

You're both half right.

One of the biggest problems in the current system of online forms, short appointments, never seeing the same doctor twice is they do not know you. For people who are struggling to get their words out, perhaps they have a disability, or cognitive impairment, or have accessibility issues, or just aren't hugely articulate, this disadvantages them and puts them at risk medically. Those that do best in this system are the very articulate already advantaged people, often middle-class, who are used to speaking up.

Those who aren't able to advocate for themselves are left behind in this system, and that's millions of older, less articulate or cognitively impaired people, people with brain injuries, people who deserve great care just as much as anyone else but aren't able to represent their entire medical history in 5 words.

Don't worry. I have torn a strip off quite a few patronising doctors in my time, and haven't felt the least bit guilty about it. Many are misogynists with a god complex, especially at consultant level.

Why not? What is the point of having notes if the doctor can't read important information which will be prominently displayed? If can afford to waste time during the appointment talking over the patient, then he can afford time to read.

You were incredibly eloquent OP and justified. I hope you’re better soon.

More broadly however, there does sometimes come a point in an appointment when as an HCP I need to steer the conversation to get key important information I need from the patient. Our notes are easy to access and I do read them.

With some patients it is really hard to get a word in edge ways, although it is good practice to let them speak for a bit first. It is hard to get the balance between letting the patient speak, asking for further useful information that they might not know I need, and then having time to sort out the problem. Some days if let everyone talk for as long as they wanted I would have an angry waiting room of people as I’d be running a couple of hours behind.

Good for you. You are right 💐

If there is one take home point from this thread (and OP you should mention this in your complaint letter), is that it appears GP records aren’t entirely fit for purpose. This screams out Quality Assurance/Quality Improvement to me. How can the practice notes and triage be improved so that GPs have instant access to the most important information prior to a consultation-
better triaging, highlight the main concerns, alerts on computer records that a GP will see immediately, summary boxes, training and guidance to enhance communication skills and patient feedback.

GP records are a nightmare and not even transferrable between hospitals. If you have a life-threatening condition or even just a severe issue, it's worth having a short written summary if you go into A and E a lot. One of my friends has a laminated A4 card with her child's information on it as otherwise you have to give an entire medical history to each doctor that comes on shift, my record is 6 recounting of histories in one day, absolutely crazy to run a system like this and to depend on the patient who is ill or may have issues to be the one to transmit important medical information, but this is not GP's fault.

Exactly this. I’m a professional in a different discipline, if my clients could walk in with a neat summary of the issues and possible solutions they wouldn’t need me.

I read the briefing notes before I see a client, I also listen to what they are saying and use that info to extend questions and capture more information.

its not just basic manners, its basic business sense. Its far and away the most efficient way to operate if you want to get to the best solutions in a short period of time.

All the PPs saying “doctors don’t have time to read notes”.

1. why are patients asked to fill in forms with all salient info to the specific appointment? Perhaps its just a handy way for the business to screen out the learning disabled, E2L patients and technically less savvy patients?

2. its a false assumption that not reading the notes, even the basic summary form for the appointment saves time. It doesn’t, it just delays an outcome and increases the risks of the wrong solution for the client.

Of course if you are paying the professional on the number of clients and appointments rather than outcomes then incentives are skewed against the client from the outset.

100% with you OP. You did nothing wrong. You assessed the way the conversations was going on and use your better English to make the un bothered doctor understand the reason you were having a consultation.
Effective and correct.

Hope you're ok op. Well done for putting the mysoginistic twat in his place. Because that's what it was.
I'm with you on the triage thing. Ours is the same and the practice staff decide who you need to see depending on their specialities. It surely saves them time if they just look at that when they call you through.