Doctors: Please treat me like that medical student who sat in the corner watching....

[steven taylor]

Sorry this is going to be a bit of a rant....

I am a university graduate with a good degree. I am also an actuary (which means I spend all day doing statistics and analytics) and have been controlling my diabetes relatively well for 17 years. In short I think I know a thing or two and would really benefit from being treated consistently like a grown up at consultations...

Last time I went for my 6 month consultation (type 1), there was (entirely appropriately) a medical student listening in... the consultant proceeded to spend the next half hour giving me the kiddie version and the medical student the grown up version....

In the end I just got cross and said "please just say to me what you are saying to him - I have a degree from oxford"

I have zero confidence this will be remembered next time....but here's hoping.....

 

[Engineer88]

Snap. I may not be medical but I have a **** good understanding through my own research.

Not on your own there.

 

[Squire Fulwood]

I bumped into my doctor in a pub once and bought him a drink. He responded by buying me one a bit later. Some weeks after that we both were banned from driving for a year in separate incidents and for reasons not unconnected with the same pub. This was ten years ago and I am more responsible now.

What I now find disconcerting is that when I (rarely) visit his surgery he does treat me like an equal and on at least one occasion I found myself raising my voice when he appeared not to understand what was going on. It turned out not to be his fault since someone had written the wrong name on the blood sample and the lab binned it.

I hope I never have to pay the price for this.

 

[mo1905]

Well done Steven. I wouldn't have bothered with the "degree from Oxford" bit but bravo for voicing your opinion. They fail to realise occasionally that many diabetics are experts on the condition and their own body.

 

[dawnmc]

Well, I'm a typical woman and need to know the ending!! Soooo what was their response?

 

[Thundercat]

It's particularly annoying when it is a young not-long-qualified doctor who is being patronising. At my last hospital appointment I had diabetes longer than the doctor has been alive. I get particularly irritated with remarks congratulating me on knowing so much about my condition in that nerve snapping "good girl" voice.

Sent from the Diabetes Forum App

 

[Jee99]

I am in England and have just moved so had an appointment with a new doctor who looked down her nose at me and began lecturing me on how I need to lose weight, exercise more, eat properly - well you know the drill. I didn't say a word but handed her my diary which I keep showing exercise, diet and blood counts. On the bottom of each page I have my local gym instructors sign each time I come in and leave they also are encouraged to leave notes about any help or observations they have given. My dietician also signs off on my monthly weigh ins and offers comments. She, my doctor glanced at the book and the letters from the start of my diagnosis which state I was 28stone 12 lbs in weight and the progress I have made over the last 5 years to lose almost half the weight (I am now 17 stone 2lbs). Her face went red but she did not apologise or amend anything she had said, merely told me to see the practice nurse in 6 weeks.
I am so fed up of this behaviour, my weight problem is not totally my fault as I was a long distant runner in my youth (the 70's) and when I stopped running was not offered any information of help in changing my diet so I was still eating huge amounts of food as I tried to stop the hunger pangs. If I had known better I would not have become obese and may not have become diabetic. Doctors should ask questions about the background of their patient before they make assumptions.

 

[phoenix]

r I have the added problem of language. Because my French wasn't that good, for a while after diagnosis I was getting the very simple version and I got the impression I was being spoken down to. (or being spoken past, I remember the first day when a nurse, who I now realise has a very strong local accent spoke at me for ages and I understood not a word)
Everything changed when I asked my doctor a question that she had to look up the answer to. (trouble is I still don't always understand the answers but at least there is attempt at dialogue)

 

[catherinecherub]

I don't think this attitude is confined to Consultants.
There are many professionals who think that they need to talk down to people as if somehow we do not have their expertise and are rather dumb when it comes to anything they say.
I always think that the measure of a man/woman's success is their ability to put everyone at their ease and not to patronise people.

 

[mo1905]

@phoenix, if I were a doc/DSN or consultant, I would quiver in my boots when you walked in lol ! There can't be many healthcare professionals with your knowledge of the condition

 

[phoenix]

@phoenix, if I were a doc/DSN or consultant, I would quiver in my boots when you walked in lol ! There can't be many healthcare professionals with your knowledge of the condition

It was because I didn't understand my doctors that I started looking things up, the problem is I didn't know when to stop!

 

[Squire Fulwood]

My DN is a lovely lovely person and sometimes I think that she has a pretty thankless task but she is more than capable of doing it. Right, that's the compliment over and now the other bit.

When she prescribed the third brand of statin after the first two had put me in a chair for a while she got the box of pills and stroked them and said, "No-one has ever had a problem with these".

I caught her eye and thought, "Yer ......right". She had the decency to blush and look away. I think the NHS uses the Terry Pratchett technique of headology. At least Granny Weatherwax still has a place in this modern world.

 

[steven taylor]

Well, I'm a typical woman and need to know the ending!! Soooo what was their response?

Well - after being slightly taken aback the consultant rose to the challenge. We then had quite a meaty discussion about some of the latest research papers I might want to go and read...

Trouble is in 6 months time it will be someone else and I will spend the first 10 minutes describing my daily regime....and trying to prove that yes I do actually monitor my bg.... and saying that yes I am aware of when I am having a hypo...and yes I do know the driving rules... oh and that's my half hour up....

 

[noblehead]

Trouble is in 6 months time it will be someone else and I will spend the first 10 minutes describing my daily regime....and trying to prove that yes I do actually monitor my bg.... and saying that yes I am aware of when I am having a hypo...and yes I do know the driving rules... oh and that's my half hour up....

Providing the consultant is still there you can ask to be seen by them rather than someone else, just mention it to one of the nurses on your arrival.

Some consultants do this and it can be very annoying, well done for speaking your mind and hope the consultant has learned a valuable lesson from you.

 

[Brunneria]

Ask an 'intelligent' question the first time they pause to draw breath.

I did this (quite unintentionally) on my last visit to the endocrinology clinic (for another health issue). I asked her about one of my blood test results, and whether they had included another hormone on top of the usual list, because the last registrar had said it might be valuable.

She paused for just a moment longer than necessary, changed gears, and treated me like an adult for the rest of the appointment. It was refreshing.

I must admit to a certain sympathy for them. They sit there, and when the door opens, they have no idea what they are going to get. For every person who arrives interested, compliant and willing to take responsibility for controlling their BG, they must get many more who forget their medication, mainline sugar, beer and mashed potato, and fudge their readings.

Mr B knows someone who starves himself and starts taking his medication for 2 weeks before his check ups. As soon as the appt is over, he goes back to takeaways, beer and forgetting his tablets. It never occurs to him that the only person he is cheating is himself.

A consultant would have to be a psychic to perfectly sum up everyone's attitude, knowledge of illness, capacity to understand AND provide medical treatment, all within 15 secs of the patient entering the room.

 

[Pipp]

That is all very well, @Brunneria , but I wonder why they cannot assume the patient is intelligent and articulate, until / unless the patient proves themselves otherwise?
I have only encountered one such consultant, in recent years, and I have seen many. She treated me as and equal partner in the management of my condition, and came up with a treatment regime that works! Her whole team work efficiently and keep patients informed by copying for us the info they send to GP.
It is not that difficult a format to follo.

 

[Brunneria]

They are used to being the brightest people (or at least the most qualified and best paid) in the room.

And let's face it, the majority of diabetics do not educate themselves about their condition. Type 2s usually don't buy their own meter and monitor BG levels (so they can't discuss that knowledgeably). Type 1s have to have a better understanding of their condition, but that doesn't mean they all go looking for knowledge. The average diabetic doesn't go on forums, exchange diet ideas, read books, keep up to date with studies or even take initiative with diet and exercise.

To treat everyone like a small percentage of patients is a nice ideal, but realistically, it ain't gonna happen.

I mean (using a loose comparison), if a teacher taught a whole class at the level of the brightest pupils, that would not benefit the rest of the class. And if I walked into a consulting room and was spoken at a level I could not follow, then I would come straight home and start a thread about how arrogant and unapproachable the consultant had been.

I think, as usual, it is up to us to signal our capacity, and for them to respond as they are able. Rather like the rest of life, really.

 

[Pipp]

They are used to being the brightest people (or at least the most qualified and best paid) in the room.

And let's face it, the majority of diabetics do not educate themselves about their condition. Type 2s usually don't buy their own meter and monitor BG levels (so they can't discuss that knowledgeably). Type 1s have to have a better understanding of their condition, but that doesn't mean they all go looking for knowledge. The average diabetic doesn't go on forums, exchange diet ideas, read books, keep up to date with studies or even take initiative with diet and exercise.

To treat everyone like a small percentage of patients is a nice ideal, but realistically, it ain't gonna happen.

I mean (using a loose comparison), if a teacher taught a whole class at the level of the brightest pupils, that would not benefit the rest of the class. And if I walked into a consulting room and was spoken at a level I could not follow, then I would come straight home and start a thread about how arrogant and unapproachable the consultant had been.

I think, as usual, it is up to us to signal our capacity, and for them to respond as they are able. Rather like the rest of life, really.

You are right about so much of that.
Just think it would be common courtesy for the to at least ascertain the level at which they should pitch their spiel. Some I have seen did not even address me at all, just spoke to his entourage about me as if I was just an object for them to craft. Similar scenario to the OP

 

[Unbeliever]

The sort of issues discussed here have a huge impact on treatment and outcomes and should be addressed seriously by hospitals and doctors.,
To be fair , some do understand the prolems but too often they are attributed to pressure of work etc.
That may , occasionally be unavoidable, but if patients were allowed more input and the right questions asked the pressures could be reduced.
Too many appointments are mere box-ticking exercises. due in some measure to the dreaded "targets " of course. This is not always the fault of the HCP - many patients have the same attitude - they just want to be see by someone-anyone- and allowed to leave asap- sometimes becoming aggressive about it .They never seem to stop to consider if the appoinment was meaningful in any way . If it wasn't then more appointments will be necessary wasting more time and mo ney for everyone.

Experience has taught me that when I see any HCP for anything for the first time I have to demonstrate that I am concered and interested about my own health and wish to be pro-active,. Some don't like it of course, but it is ofte necessary.
It can be done in various ways . Asking relevant questions is a good method as is producing evidennce like readings and diaries as mentioned above.
For T2s - whatever the official atiude of the NHS- production of a bg meter and readings even if only for the week before the appointmet always make an impact.
Of course its always easier when you are able to estabiish a relationship with the HCP but obviously when you seee someone once a year and that person sees many patients daily t is not always possible

I feel that those patients who do' challenge the attitudes experienced by the OP are doing a great deal to help others and also helping to keep Comsultants grounded as well as doing a great deal to help to train medical students etc I know that may find this difficult but the alernative helps no one and we are, ultimately responsible for our own healh.

 

[Ali H]

We are extremely lucky here, our GPs and nurses are excellent and the 2 endocrine Drs are highly approachable. I also paid to see an Endocrinologist in Bath and I had 3 meetings with him all of which overran and all of which were decent, informative and constructive without being talked down to. Our practice nurse always points me in the direction of the diabetic specialist GP as she knows my questions will fox her. I care for my parents both of which are very old and have complex medical problems and so I have at least weekly contact with the medical professionals. Again they talk to me as an individual about the various issues and they trust my judgment if I think something is awry.

We want to move away one day, I very much doubt we will find such a good surgery again.