Doctors' tendency to include a comment about the personality of the person they see in their clinical letters was noted on a Members' Only thread.
I googled to see if other people found the practice rather patronising, and certainly unnecessary. I found this:
Yes, Many People Are “Pleasant” or “Delightful,” Even “Lovely” — But Should That Be in the Medical Note?
It's interesting to read the comments to this piece. Some say that they know that patients can get access to the letters, and they want them to know that they enjoyed meeting them. Others say that they put it in nearly all their letters, again because they know patients read them, and they want to offset any description they see as a criticism such as 'obese'.
A number of commenters acknowledge that the personality description serves as a code for themselves and their colleagues about whether the patient was or was not difficult. I find this pretty concerning. e.g.
I googled to see if other people found the practice rather patronising, and certainly unnecessary. I found this:
Yes, Many People Are “Pleasant” or “Delightful,” Even “Lovely” — But Should That Be in the Medical Note?
Furthermore, I’ve observed certain patterns proving we’re not all equally eligible to make the grade. First, women earn way more “praise” (ahem) than men:
- “Pleasant”: 60% women
- “Delightful”: 75% women
- “Lovely”: 90% women
In fact, every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. Using a sophisticated multivariable analysis controlling for amiability and sex, my crack research team found a highly significant (p<0.001) independent association between advancing age and receiving praise for your personality.
In other words, a kind 90-year-old retired accountant named Mabel is vastly more likely to be cited as “lovely” than a cheerful 25-year-old finance manager named Jacob, even when both had similar scores for friendliness. Is that fair?
But — if you think about it for a moment, doesn’t this “lovely” imply something demeaning and patronizing about the label? Of course it does.
It's interesting to read the comments to this piece. Some say that they know that patients can get access to the letters, and they want them to know that they enjoyed meeting them. Others say that they put it in nearly all their letters, again because they know patients read them, and they want to offset any description they see as a criticism such as 'obese'.
A number of commenters acknowledge that the personality description serves as a code for themselves and their colleagues about whether the patient was or was not difficult. I find this pretty concerning. e.g.
It sounds as if the doctor's effort for their patient is dependent on how much they like them. I recall a study that found that we feel more favourably towards people we have helped. So, joining the dots, people that the doctor can't help, and who perhaps have come across as less than pleasant due to exasperation and exhaustion, will not receive the same quality of care.Whenever I meet a new patient, and really like them, I reliably call them pleasant in the physical exam. (Note: I never ever called anyone delightful or lovely. That seems patronizing.) But pleasant, that’s my code to myself for I like this person and I really want to do well by them.
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