[Closed] Doctors of STW - Which type of patient do you prefer - smart ass or dumbass?

Doc: “Ah ! Mr Panther, We haven’t seen you for a while."

"I know, thats because I've been ill doctor"

I'd err on the smart ass side. Until doctors have that little scanner thing that Doctor McCoy had in Star Trek the only thing your GP really has to go on is listening to your answers to their questions - nuances in your description of a symptom might be quite important, particularly in the case of something where the only symptom is something you can feel - even only in helping which physical test to try first.

Thats a bit different to getting your own google-diagnosis then inadvertently allowing that to shape your description of your symptoms though.

Also... I tentatively extend an invite to the STW hernia club. Admission pending on at least having a surgeon draw on your belly with magic marker.

I went to the doc yesterday, he made some comment to me about computers and then followed it with something like " but patients try to tell me medical stuff all the time, rolleyes".

IMO your best bet is to say "I has tummyache, I suspect XYZ based on my puny knowledge and hope it might help but submit to your expertise, O great doctor with years of experience".

IANAD (but have been accused of smartarseness)

Admission pending on at least having a surgeon draw on your belly with magic marker.

They'll struggle to find a blank space given the amount of biro annotations currently on there. 😉

Whilst there start a conversation about how you saw a program describing how AI will replace GPs and that it will be a boon as patients will get 24hr access to healthcare without queuing next to sick, poor or unwashed people.

😉

They’ll struggle to find a blank space given the amount of biro annotations currently on there.

Ink poisoning?

I’m not a GP (or any type of Doctor), but I think I’d prefer somewhere in the middle. A patient who can eloquently describe the symptoms they are feeling without attempting to diagnose themselves with something.

The one that gets them out the door in 5 minutes. Ideally with "it's nothing, it's something going around, go get this placebo of a drug and it'll be fine, etc". To be fair it probably works in most cases and the problem goes away or they die. Either way they are unlikely to come back.

New computer system at my GP practice now has the ability to send messages to your GP. So bombarding them with loads of Dr Google copy & paste 24/7.

Not that I can get on the thing. Despite being on the old system I have to re-register in person.

perchy - oddly very similar set of questions / symptoms I've got for my doctor. Similarly I want to explain all that crap that's going on or I suspect is going on, but in 5 minutes a vague, "stuff hurts, vaguely there, sometimes, will I die?" is probably all I can manage. Not considered hernia though. Also, you say left. Your left? (assuming any of it was genuine, or was this theoretical?).

Also, you say left. Your left?

Yes, my left.

Google Spigelian hernia. Then go and educate your GP all about them. 😉

Just tell them you've been Googling your symptoms and you've narrowed it down to either an inflamed fallopian tube or a bullet lodged in your stomach, so perhaps they can offer a real diagnosis.

yeah, well.. we don't let Spigelians in the club.

Yes, my left.

Best stick to "nearside", "port" or point.

yeah, well.. we don’t let Spigelians in the club.

Racist.

The Ambassador for the People's Republic of Spigelia shall hear of this.

Best stick to “nearside”, “port” or point.

Apropos of nothing, I was once in a  car breakers yard and  lots of the dismantled parts were marked with either "MS" or "FS"

I asked Dirty Jake, the proprietor, what this was for.

He replied...... " Mothers side and Faithers side"

Yes, but is it Inguinal or umbilical smarty pants?

🙂

My tummy hurts

Pfft, you're doing it all wrong. In my local surgery the middle aged, middle class, traditionally built ladies on reception appear to understand all ailments before the doctor gets to see you.

It should read something like this.......

Middle aged, middle class, traditionally built ladies on reception; “Ah ! Mr Panther, We haven’t seen you for a while. What seems to be the problem?”

Me: ” My tummy hurts”

Middle aged, middle class, traditionally built ladies on reception: “Whereabouts”

Me: “All round there”  *gestures vaguely towards torso*

Middle aged, middle class, traditionally built ladies on reception: “….and how often do you get this pain?”

Me: “Sometimes……will I die?”

Middle aged, middle class, traditionally built ladies on reception; "Ah Mr Panther, would you like to see the doctor in March 2023?

Best mate is a GP, he likes the well informed well researched and is quite happy if folk have used doctor google.  He will openly google stuff too when with patients, if only to reassure them that what looks like a horse, sounds like a horse, and smells like a horse....most likely is a horse 🙂   .... even if Dr Google says it's a Unicorn !

Apropos of nothing, I was once in a  car breakers yard and  lots of the dismantled parts were marked with either “MS” or “FS”

I asked Dirty Jake, the proprietor, what this was for.

He replied…… ” Mothers side and Faithers side”

Genuine lol

” Mothers side and Faithers side”

Now I'm beginning to wonder why have my Umbilical Smarty Pants got 'C&A' written on them.

Don't think it's a hernia I'm afraid, sounds just like cat aids to me.................

Now I’m beginning to wonder why have my Umbilical Smarty Pants got ‘C&A’ written on them.

10/10, would s**** at again.

Quick poll of the doctor in the tea room here  after I'd asked them about the queue of patients out the door, suggests that all of them welcome informed patients, however there is a fine line between informed and wingnut. So.

Yes googling is fine, stick to the well known sites (NHS for example)

Samples, less so....

In a plastic bag. . Leave with reception.

I have said in the past 'can you reassure me it's not X' rather than 'I think I have X'.

Makes me feel less of a pillock, and to be fair it's a more accurate request anyway.

Doc: “Ah ! Mr Panther, We haven’t seen you for a while. What seems to be the problem?”

Perchy: ” I have a lump when I laugh”

Doc: “Whereabouts”

Perchy: “All round here” *gestures vaguely towards groin and scrotum*

Doc: “….and how often do you get this pain?”

Perchy: “Sometimes, if I tense up while thinking up a funny one liner……will I die?”

Doc: " Are you a comedian? "

Perchy: "Sometimes"

Doc: " Can you cough while I hold these,sorry about the cold hands"

🙂

Can you not just say, “I have a pain here [point] which seems to be agrivated by lifting and I can sometimes feel a lump”

you could add “hopefully it’s a hernia rather than [an alien / something more sinister]” depending on your desire to make light of the situation!

fwiw - I believe the thing doctors find most frustrating is spending all your allotted time on the relatively trivial hernia and then when you are about to walk out the door you mention the chest pain you’ve been getting too!

Perchy: ” I have a lump when I laugh”

Currently sporting a raging lump at this. 😆

My mum is waiting for a hip replacement & while the problem with her hip was being diagnosed she was discussing the problem with her doctor & another doctor who was in there with her (for some reason; not sure why).

She tried to comment while they were discussing it and got told to 'be quiet while the clever people are talking....'

I'd err on the side of caution while talking with doctors....don't interrupt the clever people!

Samples, less so….

I remember freshers week in student halls - everyone having to sign up for new doctors.

Tim had been told to take a sample to his first appointment. From the kitchen window we could see him in the rush hour bus stop queue with a cafetière full of steaming morning piss.

We all laughed

then it went quiet

"Tim doesn't own a cafetière"

followed by a scramble to check our cupboards.

I don't do GP's after spectacularly shite support a few years back. Crap surgery led to other issues and GP refusing to treat. Moved practices with same blood tests, on treatment ASAP.

I hate going as you usually get prescribed some crap.  Went recently 'I cant help you if you haven't been'. Not been for two years as my back is buggerd from breaking it. Got to the point where I can't manage the pain.  Doc got me on some strong stuff, referred me for physio (1st time ever I've been referred yay) and paut on a pain management course.

Sometimes its worth going.

Phone conversation last time I went to the Dr's:

Me: Hi I'd like to see the Dr please

Receptionist: sorry there's no appointments today, is it urgent?

Me: I don't know, that's why I need to see a Dr.

R: Ok, if it's not too personal can you give me a brief description of the problem and someone will call you back.

Me: My left testicle is about 4x the size it should be.

R: ...........................

R:............................

Me: Hello?

Got seen by the Dr pretty promptly!

(shingles if anyone is interested)

Route 2 but replace the "There's a good chap" at the end with "But hey what do I know?"

You've got them them, no way out of it but to nod and tell you that you in fact are a very well informed and educated chap. Inside they will be seething and despise you forever but you'll have the win. I would suggest though that you go elsewhere should you ever need a prostate examination, they might just confuse the lubricant with a jar of deep heat.

I can tell you what my least favourite form of surgeon is.  It’s the one who only provides one option, the option that’s not favoured by NICE as having improved outcomes, the one who literally justifies it with a version of “That’s how I’ve always done it, the one that won’t reveal which of his fellow colleagues actually uses the method with better outcomes and the one who doesn’t want to discuss key aspects around surgery e.g. recovery, the anaesthetic approach they will use...

you could add “hopefully it’s a hernia rather than [an alien / something more sinister]” depending on your desire to make light of the situation!

You need to be wearing the right T-shirt...

I’m not a GP (or any type of Doctor), but I think I’d prefer somewhere in the middle. A patient who can eloquently describe the symptoms they are feeling without attempting to diagnose themselves with something.

Pretty much what I was going to say.  By all means describe the symptoms as you suggest using correct terminology, but leave the doctor to do the actual diagnosis.  What you think it might be is a) irrelevant and b) an affront to a professional.  By all means go "yeah, that's what I suspected after asking on a mountain bike forum looking at medical websites," after you've had a diagnosis.

Wife and I took my son to out of hours GP a few years ago why on holiday in Wales.

GP: What seems to be the problem

Mrs S: I think he has xxx and would benefit from a prescription of xxx

GP: Oh, well aren't you clever Dr Google? (in the most patronising voice possible)

Mrs S: Actually its Dr, not Mrs. I'm a GP with 20 years experience and particular specialism in paediatric medicine. I wrote a masters dissertation on this exact illness. I am only here as I am not keen on prescribing steroids to my own child, ethically, it is better that you review him and provide a prescription, assuming of course that you do agree with my diagnosis.

GP: Oh.

Wife and I took my son to out of hours GP a few years ago why on holiday in Wales.

[etc]

That's brilliant.

I'm reminded of a Twitter exchange I saw a little while ago.  Some bloke mansplaining something, said to a woman "you should read [this book] on it."  Reply, "I don't need to read it, I'm the book's author."

It's a valid OP, actually...

So, the premise of the consultation is for the doctor to have the skills (both listening and questioning) to ascertain information.
Most information is guff, but there are several vital points, both doctor centred (needed to make a management plan) and patient centered (needed to meet YOUR needs). Sometimes the two may align, sometimes they may be different. Both are needed, or else we can't really help you (...hmm, OK, we can't really help you WELL)

Doctor centered:

Pain: site, location, timing, aggravating and releiving factors.

Use dates or timeframes. I literally don't know when Janice moved next door, so that's a useless time reference to me.

Include other symptoms as well - discharge (we KNOW you have discharge...) etc

Previous issues around the area of pain.

Patient centered:

This is the bit I 'like' and enjoy teaching med students and trainees. It's generally the bit 'most' hospital doctors miss out. However, I think it's key to a good consultation.

ICE.. Ideas, concerns, and expectations....

Let the GP know what you think might be happening ("I think it's a hernia"), let the GP know what your worries are ("I'm worried it's cancer in my colon") and let the GP know what you are hoping to happen ("I think i might need a scan/surgery/finger up my booty etc"). You may be 100% correct in all of your 'ICE' points, in which case you adn the doctor agree, and everyone is happy. Sometimes your expectations may be out of whack, but it's useful for the GP to know about them so they can 'let you down with explanation why..."

I find that if I'm rushed and DON'T cover all the pateint needs, they simply come back - yes, I've treated their bladder infection or whatever, but if they specifically wanted to hear the words "you DON'T have cancer Mr Smith" then I haven't met their need....

Good luck. Cat AIDS treatment is getting better by the day...

DrP

Wee hernia here too, been 5 months now, no pain as yet, inguinal. After seeing how incapacitated my mate is after 3 months since surgery, I'm in no rush to go under the shiny thing.

, but if they specifically wanted to hear the words “you DON’T have cancer Mr Smith” then I haven’t met their need….

I wish you'd make that point to my GPs!

My gf went to our doc to get what she thought to be a suspect mole checked out- quite sensibly as a peelie-wallie red-haired scot who grew up with the 70s idea of childhood where you spend it outside. It takes 3 weeks to get an appointment with out GP so theres time for something ike that to play on your mind.

And our doc looked at it and said:

"Oh its nothing."

Not "its nothing to worry about its just a..." or "or you were right to be concerned but the signs you need to look out for are..." Just 'nothing' in reference to something that is definitely a thing.

Well, just back, went for full disclosure of material facts but reigning in the smartassery and  the GP couldn’t have been more noncommittal if she tried.

We have so far failed to rule out ectopic pregnancy, alien probing and an apple tree growing out of my belly after accidentally swallowing a pip.

Blood tests and ultrasound await.

I’m pretty sure that, if pressed, she might have confirmed that I actually have blood, but I might be wrong.

GP: Oh, well aren’t you clever Dr Google? (in the most patronising voice possible)

Mrs S: Actually its Dr, not Mrs. I’m a GP with 20 years experience and particular specialism in paediatric medicine. I wrote a masters dissertation on this exact illness. I am only here as I am not keen on prescribing steroids to my own child, ethically, it is better that you review him and provide a prescription, assuming of course that you do agree with my diagnosis.

GP: Oh

I know of a good one of those too:

Patient:  Thanks for coming; I've got a recurrence of renal colic.  I'd really appreciate some strong analgesia and a hospital admission.

Deputising GP:  Oh really sir, and where did you train in medicine ? - you seem to be very good at it

Patient:  (some place or other).  Thanks, I'm a professor of surgery and currently a member of council of the GMC

Deputising GP:  Oh, (probably followed by **** !)

Perchy - If they won't let you join hernia club merely on the grounds that you may not have one, I could lend you one of mine.  Had 3 fixed so far and I'm sure another one will be along in a minute

I’ll get in on my own merits. A 150 kg deadlift should sort it 😉

And our doc looked at it and said:

“Oh its nothing.”

Not “its nothing to worry about its just a…” or “or you were right to be concerned but the signs you need to look out for are…” Just ‘nothing’ in reference to something that is definitely a thing.

Had that with a lump I found in related area OP mentions. Me reading bowel cancer stuff and freaking out, doctor poked it for a couple of seconds and "oh it's nothing", get out the door (effectively).

Still there year later. To be fair it's pea sized and not grown, but is in the area of the general non-specific bowel type aches on and off. Though I think the lump is in the skin. Since then I'm paranoid about every weird shape stuff. Found another tiny lump, though it could be just internal bits and never noticed before.

Anyway, focus on odd aches down there has shifted to a really painful neck ache suddenly coming on last night. Almost certainly just slept the wrong way, but of course I think it's related to everything else (back aches recently too), so yeah, cat aids.

Book marking this for the next tutorial I have to do with the GP registrar. Thanks all!

one who doesn’t want to discuss key aspects around surgery

Seems like you and I have similar consultants. I'm with the nicer one of the two urology chaps now.

Looks like I may be a candidate for a steam cleaned prostate! It's got to be better than the rebore my dad had!

I totally wish I hadn't read that a minute and a half after finishing my tea.

Ok, I have a pass for entry in the STW hernia club (is that a thing).

Currently sore after having had an inguinal hernia repair last Thursday. My experience has so far been very positive.

Lump appeared about 6 weeks ago. Thought nothing of it until 4wks ago it got uncomfortable and started affecting my sleep. Took 10 days to get appointment with GP. She was great diagnosed suspected hernia and wrote me a referring letter to the surgeon at the local hospital that she knew was good.

At this point I pulled my private insurance card (working for a medical co. has it's perks). Saw surgeon the following week she knew her stuff and diagnosed without a scan. Suggested if left it will get worse, it had by then stopped me running due to mild pain). Booked me in for open surgery the following week.

The NHS route would have been the same level of care (same surgeon and treatment) but with a wait of 3 weeks to see surgeon and a wait of up to 18 weeks for surgery. I assume the wait would have an increased risk of hernia getting worse and possibility of strangulated hernia which would have meant emergency surgery. Apart from time the only other difference was I got my own tv whilst waiting to be operated on.

Surgeon seemed to think I might even be able to do a gentle bike ride within the week. I think she is nuts and am aiming for driving the car again and walking the dog. Hope to be back on the bike gently within 4wks

I do software training in Primary Care for a living, and the GP is always the best bit for me - there are some.... less polite and less open-eared, shall we say, there are some who have preconceived ideas about how the software SHOULD work, who can be spikily difficult to talk to, but the majority - vast majority - of GPs I've met are lovely, if slightly scarily intelligent.

I don't know if I've really helped there - sorry if not. 🙁

I've had fun conversations with doctors about morphine.

Me: it doesn't work.

Doc 1: oh we'll up the dose

A short while later. As admitted to ward.

Doc 2:  what's he had

med sheet: lit's or morphine

Me: hello doctor as you can see I'm quite lucid but the appendix... It hurty. Like a lit hurty.

Doc2: oh well, we'll give you some more morphin.

Me: its not going to do anything its its litterally completely inneffective i'm nit even gettinv to enjoy it.

Doc 3 (anaesthetist): we'll give you loads more.

Me (coming round): aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaàaaaaaaaaaaaaaaaaaargh

Doc n+1: whats wrong?

Me: mirphine doesnt work

Doc n+1: hmmm perhaps we could try something else...

Me: sounds good.

A few hours later

New doctor....