Adjectives used in consultants' letters. What do they mean?

[GoodnessKnows]

I've had a few letters written regarding health matters over the years. In each of them, I've been described as 'this pleasant young lady'. My most recent just described me as 'a lady'. Just out of interest, IS there a secret code with these adjectives. I once heard that there was. Just interested.

My DP was recently described as a pleasant American by a consultant in a letter recently. He's Irish and not always that pleasant! (Although I love him, obviously!)

Ah lougle that does explain a lot re mum is sensible comment! Considering we are in pead cons office re bowel difficulties, his ASD type behaviours and allergies/ epipen - all,of which I do as a job and have training in.

I'll happily translate that as mum knows what she's doing

Last time I asked a consultant how they were, the response was a terse and sarcastic 'we're not here to talk about me, are we!'

Gosh, how rude! I've known one of my doctors for so long we always have a brief chat about her family, what my children are up to etc. Makes the appointment more pleasant for me and I hope it does for her too!

Ds was described in a recent letter from a consultant as being 'extremely thoughtful'. I think that is because he had a long list of questions about what is wrong with me!

I wasn't properly listening to a Blood Nurse once and saw that he put on my notes, 'slow'. Ignorant or easily distracted would have been better.

NFN is still quite current!

When I worked in the NHS we used to run courses on writing notes. Well mostly what NOT to write really! We brought in this barrister for the course who really pinned people down on their language, helping them to understand what they had written could be interpreted (specifically in a court of law). He was very good and they always left very thoughtfully.

I don't think that 'medispeak' is a good excuse using loaded language although I know it's not meant that way, it's a) lazy and b) can have unintended consequences. I remember my midwife writing 'happy to come into hospital' when my home birth didn't work out. I was in floods of tears! What she meant was that I had agreed that I had to go to hospital.

The 'charming young lady' stuff tends to be about the rhythm of how the consultant speaks. I used to attend weekly breast clinic meetings and found it quite funny when every patient was introduced with variations on the above. I was in my twenties at the tie and most of the patients in their forties/fifties. Not young to me, but the consultant who spoke like that was in his late sixties, so I suppose they were young to him.

It can be useful to have a heads up on how a child may be , ie if they were frightened or irritable on a previous vibist. It can be helpful to know this for obvious reasons.

that website with the list of abbreviations is of course grossly inappropriate. I hope the time is long gone when they get used.

still very, very funny...

(but then I am watching Dave Allen at the moment!)

missfenella are you sure he wasn't referring to how quickly the donation bag fills up? Dh has comments on his notes about his prominent, easy to stab veins, and the speed at which the bag fills (because the blood staff didn't listen to him warning them, and would wander off to chat, book in others etc whilst his bag was overflowing- now it's on his notes).

They never took blood - perhaps they thought I was just too stupid to donate?

I had a letter once that went into great detail about my sex life - very intimate

Oops wasn't finished.. Was very intimate and stuff I had managed to confide in GP that she wanted other people involved to know about.

So she wrote - 'X is very shy. Very quiet. But xyz is going on. And abc as well. I know she should tell you herself and I know she will refuse. So I will make sure you know.'

Same detail has gone onto general notes - stuff I wish I had never told GP as all and sundry can see, even before I have met them. Wish I could remove it but on too many notes now - and it is questioned by people.

Main issue was I had told her I was struggling with a high sex drive and it was making me sore. Since then if I have a problem 'there' - have you had a lot of sex lately? How often do you relieve yourself? By what method?' Mortifying.

Making any comments about a patient - positive as well as negative - is now discouraged but 'this pleasant lady' is a standard medical letter opening and so lots of people do it from habit. It is pretty meaningless.

Some consultants never use it, some always use it and some vary according to what mood they were in when they wrote the letter and if they really thought you were pleasant or not.

Certainly when I see a patient who has been described as a 'pleasant lady' it doesn't really make me see the person any differently. I've seen complete nightmare patients another consultant has consistently called pleasant and incredibly delightful patients who have no 'pleasants' at all in there notes. It's just filler.

As said above 'denies' just means 'patient said they didn't have it'. So if I asked you 'do you have pain in your right leg?' and you said 'no' in the letter I would write 'Mrs Bloggs denies pain in her right leg'.

Finally loads of doctors actively discourage discussion about themselves. You need to have a boundary where you are the doctor and not their friend. I've had trouble in the past when patients knew I was getting married and bought me cards but a few weeks after I was trying to discharge them from the service - they thought we had more of a relationship so I couldn't discharge them but although I did like them, the same rules applied to them as someone obnoxious. As a rule your interaction with the doctor is very meaningful to you but it's likely that to the doctor it's quite clinical and you are one of hundreds.

So yes, if you have a consultation about your sex life, details of your sex life will be in the letter. But the doctor has probably heard about 1,000 people's sex lives and although you may find it embarrassing that it's in your notes, a doctor really isn't reading it like that (unless you've owned up to having sex with chickens in which case they have told everyone they know about the chicken fucker they saw in clinic today - but really it has to be very 'out there' to be shocking, they genuinely have heard and seen it all). And if you then saw another doctor about an ear problem, they will be skipping past anything not ear related in seconds as frankly clinic is very busy and they can't get distracted by irrelevant information.

I am a trainee mental health social worker and I really struggle when writing notes. I don't want to write "Tom is very concerned about the side effects of his medication" unless I am 100% certain that concerned (or similar) is the word Tom would use because Tom might not be worried, he might be bloody angry. Writing notes with zero judgements/professional interpretation is actually really hard.

wrt medical doctors

just DONT make any judgements on personality - or fricken call women ladies!

I dont see the need

" dear dr nick.
mrs bloggs has come to see me complaining of a pain in the neck. Please can you see her and sort it out"

Love doctor foster

why is any more needed?

I saw on my gp's screen in my old childhood surgery 'dysfunctional family'. I was 15 and took offence at that and said we were a happy family that had 1 member with issues. We were not dysfunctional as we had pulled together to help her.

"Pleasant young lady" sounds exactly how my NHS consultant father used to write his reports. I suspect it's like any profession including my own - you have stock phrases and way things are said. It is not code. Do not read anything into it.