Got this snotty e/mail from consultant, how to react [angry]

[emkana]

Have already posted this in Health, but on second thoughts should have posted it here, so here goes

The e/mail reads:

"I gather that you have been phoning to find out how referrals etc are progressing for Sebastian. I have not heard from the Radiologist in Bristol and assure you that I will write to you as soon as I do.

As far as the referrals are concerned, you have to understand that unless we feel something is urgent, there is a time lag between you being seen in clinic, me dictating the letter, it being typed, me checking the letter, it being sent and received and an appointment sent out. All this can take several weeks, so please bear with us a little longer.

I do understand your anxiety about Sebastian, but I must urge you to trust us that we will contact you as soon as there is any news on his X-rays and that Bristol will contact you when the letters are received."

I saw the consultant 19 days ago, and phoned up last Friday, yesterday and today to find out what was happening because I hadn't heard a thing.

And that bit where she says "unless something is urgent" - FFS ds has been unwell every single day of his young life with respiratory problems, but oh no it's not urgent to refer him to a lung specialist, not at all.

And he has problems with head control, but no, physiotherapy not urgent either. Take your f*ing time by all means.

I am , can you tell?

Funnily enough she wrote a second e/mail 90 mins later in which she had suddenly read the letter from the radiologist in Bristol. How convenient that it happened to arrive just then, I'm sure it hadn't been lying around somewhere, oh no...

Radiologist unable to make definite diagnosis btw, so no news there.

I also object to the fact that this consultant addresses me by my first name but signs with Dr. X. Probably petty, but still.

I am so f*ing livid, what am I going to do now?

Tend to agree with soapbox, if it means better treatment, more time with medical staff and less hassle, it will make a huge difference if you do go private. Think in your situation, you should really be getting more help and more intensive medical care.

I would try to find a GP on recommendation. Ask everyone you know at school and elsewhere. I used to go the nearest GP I found and it was awful. She personally was alright but I'd have an appt at say 9 and still be waiting at 1pm. My neighbour recommended someone else and it's a complete difference. So much friendlier. The receptionist knows my name when I walk in, I wait at the most maybe 10-12 minutes and the GP takes plenty of time for me. He's always concerned to get the whole picture, how I feel, what's happening in my life etc. Sometimes I even want to hurry him up!

Will have to phone the health insurance to see whether they'll pay considering it's a pre-existing condition type of thing.

Em - it id only pre-existing if it started before you were insured with them.

As long as DH had the insurance before you knew Seb had problems then you should be covered

Em, another thought -- if the health insurance won't cough up, it is possible to see the consultant of your choosing as a private patient in the first instance and then slot back into that person's NHS practice. I've done that a couple of times with the children's eyesight issues, and the cost of an initial consultation is not usually too exorbitant, although tests, x-rays and scans will bump it up rather. The insurer that I did use (PPP) had a list of recommended consultants for particular issues which may give you a useful starting point.

Hi Em. Frogs makes a good point about seeing the consultant privately just for the first consultation. It'll probably cost less than the excess on your insurance. Then just ask him to transfer you back to his NHS list. We've done this before.

Mail her back in the 'nice but worried' tone. I agree that she's probably hacked off about being chased but really that's her problem not yours. The letter should go from her office in a week maximum.

And I so sympathise with you having a dh with ostrich syndrome. Mine spent the first couple of yours off dd's life with his head and shoulders in the sand. x

Right, I've e/mailed her very briefly, asking nicely for a copy of the radiologist's letter. Bet that will p*ss her off as well though.

Will wait a few days to see if appointment for lung specialist will come through, if not will go privately I think.

Ask for their "policy" in writing about waiting times, as well as their "good practice" policy, also in writing.

Speak to this person's line manager and create a "stink" whilst keeping a civil tongue and you might be surprised. Use their words against them in that you let them know that their lip service and pat answers dont wash, and that they have to back it up with policy.

As you are well aware, you do NOT need a peurile explanation of how "waiting times" are slow etc. That is not your problem. Did they give you the usual crap about how "everybody is in the same boat"?? If so, tell them you are NOT everybody and if they recognise this problem, what are they doing about it.

I agree with previous poster, emails are useless. Registered letters only, with carbon copies to paediatricians, social services, the line managers, the managers and any one else who would be interested or is working with your child.

Having a private conversation with this person gets you nowhere. She needs to know that OTHERS know about her vacant explanations. Somebody down the line is going to look at this and may well do something to speed things up.

You can bet if it was her child, the tests and results would have been achieved very quickly!!

Dont give up, dont give in and be the original pain in the ass parent but in the nicest possible way. they will do all they can to shut you up, i.e. give you what you want to get rid of you! Thats what you want. Make this person's life a misery but never enter into an argument, just always politely ask when, where, who, how, and especially why!! get it in writing and ask her to reiterate her email in writing as well.

Who's a consultant's line manager?

bump

Your consultant may be an arse, may be lazy - they're out there, being bad at their jobs just like a whole heap of people in other professions.

In her defence, waiting 19 days to hear from her isn't too long. There's a shortage of paediatricians AND radiologists in the UK. Every time you email/phone to hassle them, you're taking them away from other patients. Sorry, shoratge of staff means that they MUST prioritise and there's kids under her care that are probably a lot sicker than your DS.

Yes, that letter from the radiologist probably had been lying around for a few days. But she might have been on-call with NO time to continue with her paperwork, let alone see to her regular in-patients.

With the drastic reduction in junior doctors' hours, consultants are left to mop up the mess; performing basic duties with no time left for the consultant part of the job - chasing up results, hurrying along appts, tests etc for patients like your DS.

You're right to be angry at the slow pace of your DS's care - but it aint the consultants fault. Her curtness and perhaps tactlessness of her email probably reflects the complete lack of time she has available.

I'm afraid I agree with soapbox and if you have private health care (even with a £350 excess), I wouldn't even think twice about using it in this situation.

You tend to get much more time with the consultant and also, if you are on the NHS, quite often once you have seen the consultant, you see their team rather than the consultant for all other appointments (which is fine for simple matters) - with private health care, you tend to only see the consultant.

Your health insurance will have a list of specialists that they use. Just give them a call.

Unless we as parents put the pressure on the "lower rungs" of the ladder, then the system will continue to remain the same. When you complain, that puts pressure on one person who then feels pressure to put pressure on another person, maybe a manager. And so on and so on.

Just accepting that is the way the "system" is at the moment, isnt good enough, which I know you are not doing by the way.

By the way, a line manager is the supervisor/coordintor of the services which are being provided. Every SLT/OT has one. The paeds refer to the clinic director. Get their names and complain!!

I'm afraid that Highlander has said almost everything that I would have said. It is highly unlikely that your consultant is sitting around on her backside enjoying the view out of her office. The fact that she has taken the time to email you suggests that she does care.

The three weeks that you ahve waited so far isn't bad in the scheme of things- it could take much longer. The fact that she emailed you again 90 mins later suggests to me that she had only just seen the letter from the radiologist, and cared enough to get back to you straight away.
That day was problably her only "admin" session, where she has to sit and go through paperwork for ALL the patients she has to deal with- not just yours, some of whom will be more urgent- those who are sick enough to keep in hospital for example. She may have been up all night whilst on-call, she may have had a patient die, and feel really down, but she did email you.

As for the head control, that happens when it happens- a physio isn't going to make much difference at this stage from that point of view. If Sebastian can't hold his head up yet, then what can a physio do to change that?

Emkana, you have had a really rough time, but as others have said, you are not going to help yourself or Sebastian by hassling the consultant or her secretary.

The Patient's Association may be able to help you Emkana.

website is here

Agree with Mamadadawaetc. - as long as we accept it as normal, it will remain normal. The PA fights to ensure it doesn't remain normal.

So tissy - what would you suggest I do then?

give the Consultant another week or so- it does take time to get letters out- the letter has to be typed then checked, signed, put in envelope, posted, it has to arrive in at the other end, be seen by the next Consultant, prioritised, sent down to the appointments office, then they have to allocate an appointmet and get it out to you. There may be a waiting list to see the specialist.

Do you know where the lung specialist works?

When the letter has been sent by the consultant's secretary, then phone the other hospital appointments office a few days later, and ask if an appointment has been allocated yet. You can let the appoinment clerk know if you would be available to come at short notice, or if you would be prepared to accept a cancellation- that way you may get seen a bit quicker.

But how do I know whether the letter has gone out?
Tbh when I phoned the secretary I was just hoping to find out whether they had sent out the letter yet. Instead I got this e/mail...

The thing is there was no inkling on my part of being discorteous on the phone, of saying "Why hasn't this been done yet?"
I just asked in the nicest possible way what the current state of the referrals was. I didn't expect to provoke this reaction.

Emkana - did you see my post on your private healthcare thread? I think looking for the right consultant could be your starting point. re this particular email I can see both sides here - on the one hand the email is badly written and patronising - but remember that the written word frequently lacks the nuances of speech and the patronising and irritated tone may have been at least partially unintended. Re the waiting times (and I speak as someone who's been through shit like this, for myself, but admittedly not for one of my babies - which must be worse) I think that - within reason - you do have to trust them. At each stage ask when you can expect to hear from them. It gives you an expectation to measure them by and puts to rest the niggling worry that your file has fallen down the back of a radiator/ and the should I/shouldn;t have heard yet thing. If you don;t hear within that time then get on the phone. And again, ask for a specific time frame for when they'l get back to you. I have enormous sympathy for you. And I too would be pissed off by the first name thing!

maybe the secretary was trying to nudge the Consultant into dictaing the letter, or maybe the secretary had had several phone calls that morning and was feeling a bit put upon herself...

not really any point trying to analyse other people's motives. FWIW, reading the initial email, I don't detect any snottiness, just an attempt to explain to you that things will take a bit longer.

Em - yes do what tissy says - but as you point out all you wanted to know was if the referral had been sent.

It's not easy to give them a bit longer or just 'wait and see' - it's not that black and white. Yes there my be sicker children out there but they aren't em's baby. It's him she sees struggle every day, it's him she's worried about and it's him she wants the best care for. And it my experience those that shout loudest get see soonest. It may not be right but it's true, the consultants repsonse proves that.

I know you need to feel in control Em. Do what you have to do. Have you sent the x-rays to the USA?

emkana - just read more of your posts - sounds like she's under a lot of pressure and was very quick to jump to the defensive. perhaps you need to ask her who you should call when you are unsure what's happening? This precise thing was the thing that really got my goat - dealing with two consultants, radiologists, GP - no single one of them holding the big picture - it's the worst thing about dealing with hospitals. In some instances there are people who are responsible for havign the big picture, chasing up your case etc - eg for me (now, not 6 years ago when I really needed it) there is an MS nurse at the hospital, I have her direct line and can call her whenever I like - is there a chance there might be someone like this for paediactrics?

Thank you ALL very much for your opinions, thoughts and advice. I really, really appreciate every post.

With regards to what I am going to do - I just don't know. I find it very difficult not to do anything, but am very undecided what the best thing to do is. So many good points have been made on my various threads over the last few days, and there are so many options that my head is spinning a bit with it all! Go private, change GP, change consultant, complain, don't complain... and the trouble is I can see some advantage/disadvantage in all of the options!

I just wish that I had what you have, womanwhothoughtshewasahat - one medical person who takes an interst, cares, helps me. But I haven't got that! In Germany (as much as I can see many disadvantages to their system, and I hated every secon in a German hospital) you can go and see a paediatrician, not in hospital, in their surgery, and if you don't get on you can change as often as you like until you find somebody. That would really appeal to me now... I feel so lost/helpless here.

Btw, tissy, in Germany they would prescribe physio for ds to help him with head control etc. - that's probably why I'm expecting too much.

God, this is so difficult.

Btw I made three phonecalls - one message on answering machine, one where I talked to one secretary, one where I talked to another secretary. Both secretaries were very friendly and said things along the lines of "I'm surprised you haven't heard yet - I'll make sure I leave a message on consultant's computer for her to contact you"

so it seems to be the consultant, not the secretary who was displeased here.

And to me that e/mail does sound snotty. I don't think it needed spelling out in that much detail what is involved in the letter writing process, and I think it's not very corteous to address me by my first name and to use surname yourself.