"this pleasant 44 year old"

[ticandtoc]

I've used private doctors twice over the past 10 years, most recently last week - and on both occasions the doctor has sent a letter to my GP starting with "this delightful 34 year old" and "this pleasant 44 year old". It has always struck me as an odd way for a doctor to describe a patient but a friend told me it's kind of a code between doctors just informing them that the patient isn't a pain in the derriere or.... ? Does that make sense? Anyone know if this is true?

Just curious.

[TwelveLeggedWalk]

Oh god, it might not be very PC but I am laughing a lot at that slang link

"GROLIES - Guardian Reader Of Low Intelligence in Ethnic Skirt"

[hashtagwhatever]

I had this very conversation with dh. I was sure there was a reason behind the Dr's choice of phrase

I am always referred as xx sensible mother on dds notes. Which I hope is a good thing?

Does that mean if you were not sensible you're any less worthy of a diagnosis.

[TortoiseUpATreeAgain]

I think they meant that she and her DH were both barristers (which they are) -- your midwife routinely asks for occupation information at booking in but I don't think it routinely gets written on the labour and delivery pages of your notes...

[squizita]

Tortoise I work in a relevant caring profession and DH works in law.

Yes, they did make a note of it.

Interesting. I hope it's not "these 2 will know some of the terminology/slang and might be stroppy so be on best behaviour" because then I would worry about patients with limited English or just very meek.
To me it made me think "hmm... are the Drs PITAs?"

[squizita]

...Oh and I have had "Delightful and determined lady with loving husband who has quite a complex history..."

Bit of a double edged sword.

[BerylStreep]

"Delightful and determined lady with loving husband who has quite a complex history..."

Determined = PITA
Loving husband = long suffering
complex history = I haven't a clue what's wrong with her

[JellyBelly10]

A doctor's referral letter once said of me that I "got a little emotional". Actually I had cried during the appointment like a nutter, blubbering and dribbling and was totally incoherent and unable to breathe, eyes like a couple of swollen strawberries and almost incapable of leaving the doctor's office!! I assume that was a polite code!

[Eruditio]

squizita as noted earlier, don't go assuming that a mention of a family member 'in law' means you'll get better treatment than the 'patients with limited English or just very meek.' I too have seen how conservatively such 'able' folks get treated. You won't be offered the cutting edge, risky-but-if-successful-life-saving-treatment'! But those who erstwhile might draw on legal aid are treated 'more carefully', if you like!

[Whatahoohaa]

It's a bit old fashioned now to do that..I Don't, but I did back in the 80s and 90 s

[wigglybeezer]

Oh dear, I was asking some awkward questions of DS2's consultant yesterday after he told me he was referring him to an elbow expert at another hospital, I wonder how he referred to me in the letter.

I also always find a way of dropping the fact that I come from a family rife with doctors into the conversation and try to use the odd bit of terminology. It is also quite tricky trying to ask relevant questions without giving away the fact that you have been frantically googling at home. It's a minefield!

[Eruditio]

See, wiggly I wouldn't be "also always find a way of dropping the fact that I come from a family rife with doctors into the conversation and try to use the odd bit of terminology"- it's been my experience that little winds doctors up more than that! You're sort of threatening them, and don't use the terminology unless you fully understand it.

I inform my GP that I'm a HCP if it's relevant because then we can have a conversation at an appropriate level; same as I'd inform them if I was an actual doctor (though again, being a rhematologist ain't gonna help a lot in a conversation about infertility!), otherwise it comes across as a 'threat', as it beggars the question that if your family is so 'rife with doctors', why don't you hold your consultation with them instead??

[squizita]

You won't be offered the cutting edge, risky-but-if-successful-life-saving-treatment'!

Already am getting that care ;) and was told 'off the record' by a couple of HCPs the swift decision to push me to national centre level was because I was pleasant/'on their level' and clearly felt comfortable in the company of HCPs and wasn't "silly or hysterical" ... hence my comment about what if I wasn't?

DH never had to mention his job... he turned up red in the face at A&E clutching a wig tin and brief like any other husband. He deals with prosecutions involving MH cases and violent crime involving vulnurable people, never sued anyone or overseen a contract in his life.
A little sad he will have to get changed en route in future if i get squashed by a bus!

The main warning I have had (from a midwife) is that if he ever turned up at a labour ward in his work clothes it raises the chance of being pushed into a C-section in pregnant women as before something were possibly to go wrong many surgeons would want to belt-and-braces it.

[squizita]

Eruditio ...Also from my experience with other women locally who have had recurrent miscarriages (for example) the more 'middle class' women with jobs in caring (or legal) type jobs simply got better care. The ones who got really fobbed off tended to be either very young (16-22 or so), have limited English or an accent, be reserved or depressed or unemployed/SAHM. I've heard "nice" comments about me "deserving" to have the treatments and trials because I'm "normal and educated" (I guess they meant "very similar to me") from a nurse - implying perhaps that some others don't in their eyes?

From a patient standpoint, it doesn't seem to bear out But those who erstwhile might draw on legal aid are treated 'more carefully', if you like!

[70isaLimitNotaTarget]

@ the link to the terms.


I have seen some GP referrals that have made me think hmmm and wondered what kind of GP:Patient relationship is going on, they aren't exactly complimentary.

Though I have patients that I detest spending time with I'm never anything but polite and professional with them.

If I have a narky female patient, I write "Lady" rather than patient (I think you can get alot of venom into that word, like a New York Traffic Cop "Hey, Lady can you wait there" kind of thing.

Not sure there's an equivilant for man though, "gent" maybe? Gentleman?

[mawbroon]

I had "this pleasant 40 year old homemaker" from a MH referral.

I could not stand that doctor, he was an arse. When I was really ill, I swore at him and called him all sorts.

But I still got "pleasant"

[Catypillar]

I'm an old age psychiatrist.

I describe patients are pleasant, delightful, etc, at the start of the letter if the terms apply- as a psychiatrist I make a much more detailed description of their mental state later in the letter anyway. I once saw a letter that described a man as "this cheerful, whimsical gentleman" don't think I would have thought up such a phrase but it described him perfectly!

I've never seen things like GROLIES in actual notes- just something that's occasionally joked about. I have various skirts made of sari material that I wear on very hot days- on one such day I was flicking through a copy of the Guardian and my colleague appeared at my elbow with a WAIS-III (most commonly used IQ test) and threatened to make me do it.

Years ago you could say what you liked in letters- my favourite was "this boy and his mother are both idiots" in a letter from 1950-something- imagine how much trouble you would get in for that now!

[Elledouble]

Best thing is when you get a MH assessment and they mention how you are dressed I realise it's probably just to indicate how well you're taking care of yourself but when I read "formally dressed" it did sound a little like I'd attended in evening attire. I was actually wearing a suit, I was on my way to work!

[squizita]

My MH assessment had "level headed and sensible" followed by a suggestion of CBT for anxiety regarding hospitals/fears. Reading between the lines I think they may have been emphasising "Squizita looks like she's calm, sounds like she's calm, and usually is but is shit scared of certain medical rooms/situations."

Which was just about right. I seem to come across as a pleasant, undemanding and informed patient during the appointment then they see me uncontrollably shaking/sweating in the corner of the waiting room or toilets.

I thought it was quite a subtle way of doing it! :)

[Catypillar]

How you are dressed is relevant- is it appropriate to the situation, are you looking after yourself, etc. A good mental state examination always starts with a description of the patient's appearance, ideally good enough that someone else reading it could get a picture in their head of how you look and behave. I would maybe have written something like "formally dressed in a suit; on her way to work." ( I also find it useful to see from other psychiatrists' letters how a patient normally dresses (ie at appointments when they have been well)- for example some people are always dishevelled whereas if I saw you in clinic when you were on your way to work and you were scruffy/smelly I would be more worried.

I have bipolar disorder myself and sometimes see the letters from my psychiatrist about me when I go to the GP- once I saw a letter from the previous week that described me as "irritable" and I was like "WHAT THE FUCK, I AM NOT FUCKING IRRITABLE, HOW DARE HE" then realised it might be true then... (I was hypomanic at the time)

[Deverethemuzzler]

Caty I was a medical secretary in the 80s. They were just beginning to warn medics about their use of language on notes then.

I don't remember seeing anything as overtly nasty as 'this person is a fool' but there was a lot of superfluous and judgmental stuff in the notes

'Black woman of 24 wearing a very short skirt. Probably on drugs'

Can't imagine seeing that today.

24 year old woman showing signs of confusion/aggression. Awaiting toxicology results....maybe?

I worked for a lovely consultant but he didn't half come out with some corkers. I saved his skin a few times

(he didn't write the above example btw. That was an SHO)

[wigglybeezer]

Eruditio, I think you are imagining me as more confrontational than I am, I don't use it as a threat, I tend to tell HCP's that I am not squeamish as I am used to discussing medical matters and that I prefer to have procedures explained fully as my medical relatives will want the details, I don't always do this of course but This is all in relation to a serious trauma DS2 recently suffered which resulted in a rare and nasty surgical complication, which my Dad had never had to deal with before, if it is a weird rash or sore throat or something I usually ask him first.

By terminology, I mean learning a few relevant anatomical terms.

I am always very polite as I always look at things from the Doctor's point of view as well as my own. I apologised in advance for asking an awkward question and told the consultant that I was reassured by his answer so hopefully he won't have described me too harshly.

[beccajoh]

I love the way doctors write their letters My consultant refers to me as "This girl". I'm 34. Not sure whether that's good or not