Outrages at appointments : This is more of a gripe... - LUPUS UK

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Outrages at appointments

awareness75 profile image
40 Replies

This is more of a gripe, but I'm interested how it is around the country, both male and female. When did it become common practice to have health professionals additional to your doctor/consultant, sit in on every hospital appointment you have?

I don't remember a public memo or being given the choice for this type of thing.

I'm not an exhibit and don't really like the obligated idea of having to discuss or get undressed in front of students or other support staff.

If your Lupus clinic is like mine, the room is very small and with up to 4 people in there at one time, won't keep coughs and germs away.

Just wondering if this is done mainly with female patients, as they're less likely to say something than men perhaps?

This never happened 10 or so years ago, so does anyone know why it's trying to be part of the normal now.

It's also a waste of resources, having nurses or student doctors sitting there, when they could be better utilised with another patient and help keep waiting times down.

You're only asked do you mind others in the room, AFTER you enter not before, which then makes an awkward situation, so your obligated to say yes, when you'd rather not, if that makes sense. Sometimes, You're not even asked!!

Just wondered the thoughts and experiences of others on here.

🙂

40 Replies
awareness75 profile image
awareness75

Title should be ontrages not outrages. Won't let me edit it.

PMRpro profile image
PMRpro

How do you think specialist nurses or other HCPs learn to be able to care for other patients? And medical students are not allowed to care for a patient alone UNTIL they have learned the procedure and passed all their exams.

They can do role play in training but the only people who can really convey how our disorder affects us is US. I'm sure you have the experience that even your family who live with you or friends who spend a lot of time with you don't REALLY "get" it. So how could even an actor portray us successfully. We often struggle to express how we are affected - someone who hasn't lived it has no chance.

I recently participated in a study relating to the pain scores - a primary question related to the fact the patient gives a higher figure for their pain score than the doctor expects from their assessment of the disease activity in examination and lab results. Now I can explain that to doctors and students/HCPs because I have experienced it. How could anyone else? And when they learn it from us, they remember it.

Personally I think this sort of training is definite progress and I never turn the opportunity down. But you SHOULD always be asked if it is OK. If they don't say "This is x, a medical student sitting in today, is that OK?" - that isn't OK. However, if you say no you are removing an opportunity to teach trainees about your disease with a real example, not a computer image or plastic model.

awareness75 profile image
awareness75 in reply to PMRpro

I appreciate your comments but there's enough patients out there, who have general health or intermediate health concerns, who are not having to remove their clothes etc...that serves the human purposes to further and enhance students career.

This isn't limited to just Lupus appointments, but hospital appointments in general.

Most people know how complicated Lupus is and also, if you have other additional conditions added to the mix, as well as the personal one to one aspect.

Maybe that student wouldn't be experienced enough to deal with multiple conditions at that stage, so the patients privacy is more important here.

I wouldn't expect to see my priest or solicitor if relevant, along with other members of that professional in the room with us.

My point is, there are trials and studies, patients can put themselves forward for, if they choose to, I don't see why additional staff is now expected at every appointment.

PMRpro profile image
PMRpro in reply to awareness75

I think you are missing the point - it is part of medical training. And NOT something that could be learned from any passing body. these are all HCPs, the same confidentiality applies and frankly - I'd far rather have a junior doctor or rheumy nurse who'd learned their trade in this specialism in the real world.

But as I say - it is your right to say no. I'm not going to.

SjogiBear profile image
SjogiBear

After my last visit to the rheumatologist, I do feel we should be able to opt in or out of being an object of study. I was thoroughly fat shamed to the new doctor sitting in on my last appointment... completely made to feel like some fat lump of meat on the couch talking over me as though I wasn't there. I get stressed enough about these appointments without being treated like an object rather than a human being!

awareness75 profile image
awareness75 in reply to SjogiBear

Now that is horrible and wrong.

Sashappy profile image
Sashappy in reply to SjogiBear

Tell the nurse you do not want any additional students in the room it will be fine.

baba profile image
baba

if you don’t want them there you can say no. And no means NO

marypw profile image
marypw

It was actually my GP together with a trainee who diagnosed me with lupus - the trainee noticed how stiff my hands were.Our GP surgery is a training centre, so there are often trainees there - I'm happy for them to learn.

(Although now all my rheumatology and cardiology outpatients and GP appointments are over the phone, I don't know how HCPs get trained anymore!).

AgedCrone profile image
AgedCrone

You are supposed to be asked if you give permission for anybody to sit in on a consultation.If you would rather not you are within your rights to refuse.

Sashappy profile image
Sashappy in reply to AgedCrone

I noticed they do not always ask you anymore. You need to tell the nurse before entering the room.

MusicalFurbaby profile image
MusicalFurbaby

Hi Awareness, good question! Yes, you can absolutely say no, we patients have those rights on our side. I will add, however, that in my experience in Australia it’s completely normal to have students sitting in on many appts, especially in a public hospital. They have to learn somehow, and the best way for many students to learn is by doing, not just watching. I have no problem with this most days, but if I’m there for a sensitive issue, I will request more privacy. When it comes to rheumatoligical/immunological appts or anything remotely related to lupus, I’m actually keen for students to sit in, because they need to learn as much about autoimmune disease as they possible can! If nothing else, I can help to educate the next generation of doctors! Hope this helps x

KayHimm profile image
KayHimm in reply to MusicalFurbaby

Yes, it can be a great way to be heard!

cathie profile image
cathie

whenever students have sat in at appointments I’ve always been given the opportunity to object. I assume it’s a mentoring part of training. If we want more doctors it’s necessary.

Chris_O profile image
Chris_O

Hi.

I’m on a different forum, but my comment ties in with your feelings. Not long after I’d had a heart attack and was lying in a cardiac ward, a doctor came around ( I assume he was connected with the cardiac ward ) and started questioning me about a skin condition on my forehead. He then brought a junior colleague to show her, and asked if it was ok, as a afterthought. I joked about how much I charged for charged for medical lessons. Afterwards I began to think about what happened and realised that I would have been happier to be just left alone. I think now that when any thing happens like this in the future I will have no hesitation in saying ‘NO’ if I don’t want to participate.

Chris_0

awareness75 profile image
awareness75 in reply to Chris_O

Something similar happened to me. I was experiencing pain in my chest and ended up in after hours A&E because it was the weekend. The doctor asked me if it was OK for a student to be present. On this occasion I agreed. The doctor was examining my chest, but then started talking about me to the student and then told her to examine me also!!He didn't ask if this was ok, to be passed around like this.

I just had my mastectomy, so you can imagine how uncomfortable and vulnerable I was feeling at that stage.

MrsMarigold profile image
MrsMarigold

Hello awareness75. I’m in the USA. Generally we have the same situation at hospitals; especially teaching hospitals. My first two children were born at teaching hospitals and I was asked from the very beginning of my pregnancy if a student could follow me along the course. This was almost 35 years ago. The student was a young woman. When a woman is pregnant and gives birth the right to privacy is relinquished. I could have said no. But like PMpro stated above, I just thought if this helps her become a great OBgyn then ok; despite my nervousness. My second pregnancy was much the same. Fast forward to my 4 th pregnancy: I had all my children very close together. Unfortunately my own Dr. was out of town with a personal emergency. The bozo Dr who walked in just glanced at me and told me not to push until he was done writing his notes. Really? I yelled to the nurse or anyone in the room that my baby was coming right now!!! My son was deftly caught in mid air by the nurse on call ;now a nurse practitioner, who examined me throughout my first pregnancy. I was beyond grateful to have her there. Not just because she caught my son! She listened and knew that what I said was true. She gave me great aftercare as well. Really fast Forward 2022. My last neurologist appointment I again was asked if a student could listen in. I said yes. Best Regards MrsMarigold

chrisj profile image
chrisj

You can ask for them to leave if you don't feel it helps to have them there, you have that choice, its not compulsory.

At my last invasive appointment I was asked if I minded a trainee doctor being there, I had the choice of saying yes and he would have left. Yes its uncomfortable but as you feel so strongly about it you need to let them know.

Chris21 profile image
Chris21

I can remember having students sit in on my consults more than 10 years ago, not so many these days but that might be because most appointments are done by phone calls.

I don’t mind students sitting in on my consults but then I’m a person who will sit and ask them questions, I’ve even had students at the dentist.

I will always be grateful to the medical student while in a hospital bed with the consultant not having a clue what was wrong, me in tears and her telling me she’d get to the bottom of it and she did! She is the one who said I had lupus. Sometimes I find students bring fresh ideas to the table, while the ‘long tooth’ consultant is stuck in the dark ages, with the regular pills and potions and ‘I know best’ attitude.

Having said this, everyone has the right to say no, If your’e bothered by others in the room, ask the nurse/receptionist before entering if there’s likely to be anyone else in the room, that way you save yourself any awkwardness you might feel.

insti122 profile image
insti122

I am happy to have a student sit in with my GP but I had such an unfortunate experience during one of my combined rheumy and dermatology clinics in hospital that I say no now whenever I am asked. In a small consulting room I was waiting for my 2 consultants to come in when the nurse who is normally present asked whether some students could join us. I said yes but then four junior doctors and the dermatologist's senior reg came in making a total of eight plus me crammed into this small room. While I was talking to the dermatologist his senior reg spoke over us repeatedly and moved closer and closer to me until she was standing by my shoulder (during one of the covid lockdowns). At one point when I was talking to my consultants she reached forward, touched my eyelid and pointed out the discolouration to the students. Taking their cue from her the students then started asking questions and interrupting me. It became more of a three ring circus than a consultation.

I was disappointed that neither of my consultants made any comments about what was happening.

At my next hospital consultation I was again asked if the students could come into the room but I said no. I would be happy to speak to the students separately but I do not think their training should take precedence over my consultation.

KayHimm profile image
KayHimm in reply to insti122

It sounds like their curiosity and interests took precedence over your needs as the patient. I agree. Not good. The senior consultant could have used that as a teaching moment: never interrupt the patient and don’t treat them as an object.

tree_shadow profile image
tree_shadow

I know it has been standard for years when I met with haematologists for there to be senior nurses or students present. With the rheumatologist not really. But I did feel that the haemos were better organised and I actually prefer having more minds at the "table" than less.

Broseley profile image
Broseley

I was grateful to have the nurse sitting in on a recent appointment, as she was able to interpret what the doctor was saying - I couldn't understand his accent!

Babsy2 profile image
Babsy2

I personally don’t mind. Last time I was in hospital I was asked if the student could take my blood sample. I agreed, and the young man was excellent. I’ve had a lot worse from the phlebotomist..

OldTed60 profile image
OldTed60

It is a difficult one. My main concern is that it changes the dynamic of a consultation when strangers are present and I would always want to be asked before we’ve entered the room.

I am under multiple specialists and have had both experiences many times - usually students but sometimes trainee consultants. I’ve had every part of me examined in detail - often with multiple attendees. I’m usually asked out in the corridor before we enter the consulting room and feel this is a good thing because I want as many new doctors and emerging clinicians to learn from patients with long term conditions.

There is a national shortage of GPs and so much clinician burn out generally now that I see my role as a rare disease patient as very important.

However a year ago I was getting help with a crime I’d been subjected to from a stranger. I was given a police referral to Victim Support. The person I was appointed was a retired GP. It really helped that she knew what my medical condition was, having done spells of training in the CTD clinic I attend, also dermatology. She really helped me move on.

During our last phone call we spoke about how it can feel to be the focus of students - especially with intimate parts ie vulval cancer or bowel exams I was having at the time. I explained that I was feeling very delicate because of my experience being victim of a hate crime and didn’t know how to explain this to my consultants. She actually gave me name of a vulval skin specialist she’s sat in on to request and told me something about her long experience of being a GP and how much she and her students had learnt from patients like me who were willing to share how it felt to be us. Equally she understood that I had a lot of anger and distress and feared it might come out inappropriately one day.

After talking it through with her over these sessions I realised that it was the perpetrator’s problem not mine. And I slowly stopped feeling so scared and angry.

In fact I am very keen to help recruit more doctors and nurses by being as open as possible - making direct eye contact with them where possible even when the specialist was doing a very intimate exam and showing students how to do this. I hope this helps remind them of the all important human dimension in medicine.

When I’m on my own with a clinician I like and trust then that’s a massive bonus . We can say things that neither of us would say if there were students present. But it can work the other way if a doctor is not good. Students can sometimes help bear witness to bad consultations and learn from this too.

But this is just me of course. I realise it wouldn’t apply it to all and I’m lucky to mostly have great female specialists who have always been extremely sensitive during examinations - just as I’ve always been open and not cared too much about others seeing my body parts. It would be different I am sure if this was about my state of mind but I’ve always viewed my body as separate to who I am ie I’m far more than the sum of my dysfunctional parts.

And I’m losing weight very fast due to a secondary neuro gastro condition now. But when I was still very overweight, I dreaded anyone fat shaming me - as someone here has described. That would be dreadful and I think I’d have to write to the consultant who did this and tell them exactly how it made me feel.

It’s a very personal and no one rule fits all basically. We absolutely should be given the choice and not feel awkward about saying no.

DebbieJ6894 profile image
DebbieJ6894

I think it's party for training purposes (student doctors etc) and when a nurse is there with the doctor it's a chaperone. I've also noticed that all appointments I have for every ailment (incl non-rheumatology) include a chaperone. I assume the NHS is trying to avoid "he said, she said" situations.

Partner20 profile image
Partner20

Our local hospital is a university teaching hospital, and all literature and online information references this. However, we are always informed that we can refuse the presence of students if we are uncomfortable with such situations, although I do admit that it might be difficult to express this at the time. I have usually found students quite a useful addition to a consultation, particularly if the consultant actively involves them, but I think it depends on the individuals involved, both patient and medics, whether the outcome is successful. My partner recently attended a hospital consultation where the consultant was a senior lecturer and had a student with her. Unfortunately this consultant used most of the appointment time in private teaching with this student, giving my partner just 4 minutes of consultation after calling him in, not addressing his issues and making inaccurate remarks on the resulting report letter. Hugely disappointing, to say the least, but maybe a reflection of how some consultants view their patients. Needless to say, our GP was not impressed, and we shall ask not to be referred to this particular consultant again. Hopefully there are more good consultants and teaching experiences than there are bad.

Jumper99 profile image
Jumper99

I’ve often had students sitting in on my appointments. Frequent at St Thomas’s when I was a patient of Prof Hughes 20 years ago. So it’s been around a long time. My GP also has students sometimes. I’m used to it. I can understand why they are there.

But we are all different in our needs and in what we find acceptable. You should never feel obligated to accept them so you need to change your thinking on that. Or when you check in with the receptionist or whoever then tell them that you don’t want students there. Some of my consultants have a female nurse sitting in the room as a chaperone and that must surely be acceptable, it’s safety for both you and the consultant. If you don’t like getting undressed in front of everyone then ask them to turn away, or go behind the curtain round the bed if there is one.

You don’t have to accept anything you’re not comfortable with, but you do have to tell them what you want or they won’t know.

awareness75 profile image
awareness75

I appreciate all your comments regarding students, but I don't want to lose sight of my original post. I used the words health professionals. OldTed60 has made some very good points and scenarios, which I agree with.

Not everyone in that room is a student or learning scientifically and just for a moment, can I come away from Lupus appointments.

Sometimes the extra person in the room, is the one who calls you in, so you would have to say to them there and then 'I'd rather you wasn't in the appointment' hence an awkward situation.

I have breast cancer and a retina detachment and at those appointments, there's no students, just nurses or other support staff. Do I need them in there? Should they be there? Probably not in my opinion.

The 'health professional staff' most of the time are nurses and are just standing in the corner or relaying back to me, what the consultant just said. Some of my consultants are female, so that removes the 'chaperone' idea. You, the patient used to get asked if you want one, not the consultant.

Key message here is, you should be asked or notified that someone will be in the room beforehand as standard.

I could be wrong, but most responses in this thread are from women? Who are used to being poked and prodded/viewed at from cradle to grave.

I'd be interested in any male experiences in general appointments etc...

Maureenpearl profile image
Maureenpearl in reply to awareness75

The health professionals are there to assist you and the doctor. They have some training in knowing how to be discreet and you may feel embarrassed but they probably didn't look too closely at you when you were undressed.

Getting undressed with a male doctor is also the reason why the person stayed in the room so the doctor couldn't be accused of touching you inappropriately.

stillsdisease profile image
stillsdisease

note my diagnosis is Stills Disease which for me manifests as rheumatoid joint pain, with swelling and stiffness as the main chronic symptoms. I was just 17 in 1979 when I was stricken with this rare AI disorder and after 4 months of my family doctor prescribing antibiotics I was lucky enough to see a locum who immediately admitted me to Addenbrookes Hispital which at that time was a new super teaching hospital. Diagnosis is via exclusion and on one bad day when all the symptoms went into overload a handful of young white coats were ushered to my bedside to be shown the rare rash and swellings that had appeared. The Prof. told them “ you may never see this rash again so remember it well”. I’m grateful I was involved in their education.

Blearyeyed profile image
Blearyeyed

They do need to learn on the job as PMR says , and sometimes , I have appreciated the presence of an intelligent new doctor or nurse , as on a few occasions a question or comment they made to the actual Doctor was something I wanted to ask myself , and provoked them to do checks they may not have done otherwise .

But many of us don't feel comfortable in that situation or our stress level in an appointment is bad enough as it is and then it makes it harder for us to communicate what we need.

If that is the case you do have options.

When you enter an appointment with a trainee , or a gaggle arrive around your hospital bed the Doctor in charge is meant to introduce them , and ask if you are happy to have the other medica attend , observe or take part in your examination.

You do have the right as the patient to refuse their inclusion .

The way to do it is to express with apology early on that you don't feel comfortable with the observers and it makes it hard for you to remember what you want to talk about , and that you would basically prefer to have the consult just with the doctor or any staff members that definitely have to be there . You need to consider the pros and cons in refusal based on the type of appointment or situation , for clinical reasons not just because it might be frustrating to the doctor and the student.

In GP surgery situations it is easier to refuse , unless the new doctor is eventually going to be a long term part of the surgery team and could be seeing you for appointments in the future , then it's better that they have met you first.

In a hospital situation it takes careful consideration before refusing. Sometimes some people in the group are other doctors or nurses that will actually been more involved in your day to day care and appointments , follow ups , routine checks etc. , especially if you are on a surgical unit , or, they will be present and taking part in your surgery or test procedure so it's important for them to attend and hear the same information from you as the Senior does.

Then they won't make errors when they give you treatment or change drug doses .

Sometimes , they will be the ones giving a gentle reminder to the Senior doctor of something you told them , or in your notes , that the Consultant might have forgotten which you can't do in an Emergency or if you are not fully awake.

And often , they will notice that you may be suffering from other illnesses and syndromes alongside the one you were originally sent for and it could be making a difference to your progress rather than the more tunnel visioned approach of only looking at the issues relating to your current diagnosis, which is common with more senior doctors.

It used to annoy me , but now I use it to my advantage . Often the Consultant can be stand offish , in a hurry , or unwilling to listen to your experience and point of view, especially if you have suffered with a condition for sometime and have a more current set of knowledge on your condition than the Consultant does. If you ask the questions , or address the comments to the room , or the most friendly face , the Consultant feels obliged to discuss it properly because of the presence of the trainees and not simply dismiss your comments and concerns or rush you through. Over the years , my experience has been that I got more out of a consultation including trainees, and more consideration in a physical, than at a one to one with no other people witnessing the event.

I realise that it may appear Nurses or other staff in a room may appear not to need to be there , but often a complication can occur in communication or in the examination that requires there assistance , or the need for other staff members to be fetched to help in a complex scenario with a second opinion , to collect supplies or bring in another doctor for a second opinion.

I understand, that it would help to hear the view of more Men . Unfortunately, it can be less common for Men to reply in posts and more patients with experience to input on forums are women. Believe it not , women don't get more used to being poked about even if they do get more routine female examinations. Often there are other Life or Trauma events for women that make examinations in front of people even harder to bear.

I can give you the perspective of a man , as I accompanied my Uncle through his treatments for Prostate issues and Pancreatic Cancer. He did appreciate the presence of both me to calm his nerves and act as his advocate when nerves could make him feel speechless , and he appreciated the times that the extra staff member could step in to help him dress or made a comment from behind the curtain at times when he may have been having difficulty with the exam because he needed to change position . Often that staff member is keeping an eye on one end while the doctor pokes the other!

It is always your right to choose though.

Redlady9 profile image
Redlady9

Hi, as someone who works in outpatients clinics, we are supposed to ask before patients are taken in to a consultation if there is a student in the room. As far as a nurse or HCA being present for examination, it is a requirement for the doctor to have a chaperone present so that there are no allegations of inappropriate behaviour. Sadly this is necessary in our litigation prone careers. Most doctors wouldn't be happy to examine you without a chaperone and I don't blame them. However, you can opt to speak to the doctor alone if you wish. Hope this answers your question. X

Suvi8901 profile image
Suvi8901

I volunteered to be a patient for some 4th year medical students in my town as a result of being asked by one of my NHS consultants, a vice chancellor and diabetologist!

I have a range of mainly autoimmune medical conditions: type1 diabetes, SLE, DLE, vasculitis, lupus nephritis, primary hypothyroidism, lupus nephritis at the last count..😱!

My consultant told me to be myself with ALL my conditions!🤣.He thought and told me I would make an interesting challenge for these about to qualify medical students.

I’m very pro medical education and being very open and honest about all my autoimmune disorders thought it would be a good idea to flag up all my conditions and be questioned by these future trainee “doctors”?

What happened at the medical school?🥺🧐

Their supervisor/assessor told me to “tone it down “ with symptoms, signs, tests for Lupus and that these 4th year students would find it all too complicated and difficult to PASS their assessment!!!😰 (This was a GP and also a p/t medical assessor)!

Worst still a group of disgruntled medical students made a formal complaint saying that they “wanted ‘easier’ patients” to assess and that I was too complicated to assess to pass this assessment!

I was told that most of them who complained about me had failed their assessment!

They got their way and I was thanked by letter but told not to come again with no explanation!

UNBELIEVABLE? 🥺

Absolutely true. At my next appt with my consultant, he confirmed this with me and said that my range of autoimmune conditions was far too complicated for these “poor” medical students who all wanted to pass!!!

Hopefully this does not happen at other medical schools where seemingly the students get their way?

I noted his embarrassment.🤣👆

What’s this a medical mafia?

Pathetic!

How strange that medical students want an easy ride.

I would have thought that the more complicated and challenging patients were for medical students the better? How wrong I was.

I’m now disillusioned with my local medical school.

Surely this sort of attitude is not desirable or acceptable from these “ powerful “ medical students whose complaint was seemingly “endorsed”?

I’m aware that PMRpro and others give a different story.🤣. Is it any wonder that us “ lupies” continually meet up with ignorance and prejudice at all levels? This lot of medics all wanted an easy ride to qualify?

I can understand that.🤣👆

awareness75 profile image
awareness75 in reply to Suvi8901

I like your post and would emphasise the point to the others, that you volunteered to be seem along with students, which is different from not having a choice beforehand. You also reiterated the point that Lupus is a complex disease and in my opinion and based on my own diagnosis, it took very experienced selection of doctors to recognise it.

Appointments are now becoming few and far between, so as a patient, I would rather have onethe best health professionals in their field sat in, that will primarily benefit me .

I would just add to that, depends on when you were diagnosed as well. Mine was 17yrs ago, when hardly anyone; health professionals I'm addressing here, knew anything about it.

Suvi8901 profile image
Suvi8901

Thanks for your response.

I’ll try and answer your questions and comments sequentially and give you my experiences.

Before my lupus nephritis diagnosis in 2016 by a consultant NHS nephrologist I was suffering red, painful rashes all over legs and back not only on my face! This was around 2013. My GP + his assistant could not diagnose the cause so He referred me onto dermatology. Skin punch biopsy around hip region confirmed DLE and SCLE. (My other diagnoses include type1 diabetes, 1990, vasculitis and primary hypothyroidism circa 2005).

MY SCLE and DLE must have morphed into lupus nephritis which is probably true!

You talk of specialist lupus doctors! Or wanting one?🧐

But in the U.K. they are a rarity unless you go private eg in London. Since lupus affects us all in different ways with different tissues, organs and organ systems being affected and attacked by inflammatory processes we are forced to accept different specialty doctors. A “when and if “ situation?👆🧐

I think the concept of a specialist lupus doctor is almost a contradiction? Eg what would a lupus doctor know about lupus nephritis. I’d rather see a kidney specialist wouldn’t you?

Many here speak affectionately of their “rheumies”/rheumatologist seeing them periodically but I’ve never been referred to one! They are often seen as “Lupus generalists”? And mostly refer on as to what organ is affected.

With any consultation it’s only courteous to ask the patient’s PERMISSION if another health professional for training purposes has to be present. One must be assertive enough to say No. Before your appt you may not be forewarned unless it’s a teaching hospital so the expectation should always be there. Still it boils down to saying “NO” at the time.

And of course your answer respected.

Have you noticed how NHS appointments letters will always say “you will be seen by the named consultant or a member of his team “?

Unfortunately we, as patients have no control over this unless you’re willing to go private. I’m personally unable to do this or want to.

As for many video consultations these days it’s almost impossible to guarantee one’s privacy ie not having others sitting in the room even if one has said No!

Regards

KayHimm profile image
KayHimm

Hi awareness75 -

I totally understand your discomfort at having the student doctors and nurses in the exam with you, particularly if you are in a gown. I had a medical dtudent sitting in with me last week in a neurology appointment. I was fully dressed, which makes it less threatening. My doctor had to tell her to introduce herself. She seemed nervous but did ask a good question.

As PMRpro said, it is the way training is done. They do a rotation in rheumatology and have to be there to actually see how the senior doctor examines and interacts. They discuss the patient later, which is all important in learning.

If you are not comfortable I think you have every right to tell the senior consultant that you prefer they do not use you as the learning case. As you said, there are other patients and at any given time we just may not be up for a group of doctors taking turns listening to our hearts or examining swollen joints.

The patient is the priority and that is also part of the training.

XX K

StormySky profile image
StormySky

Your question was about what other people's experiences are. Mine is that there are a lot of students in appointments at present. I think with Covid several missed their clinical placements, so they are trying to catch people up. Usually I am asked, like you, after I have already gone into the room and they are already there and have clearly already read my file. In general I understand it helps with their education but sometimes I do feel like it is a 'freak show' with the doctor 'showing off their exhibit'. I think my worst experience was when I had an appointment with the consultant. There were a few people in the room - I have no idea who they were. The consultant started by enthusiastically telling me I will never get better and that things will only get worse whilst smiling at me. She seemed very excited to be able to deliver me that news. I was very shocked as things have improved overall and I had never been told the outlook is so bleak before. It didn't sound like good news that she should be expressing happiness over. One of the people in the room just continued scrolling through something on their phone, appearing totally uninterested. I was desperately trying not to cry in front of so many people as I was very aware of the majority of them just staring at me. The consultant asked me a question and I managed to blurt out 'I'm not sure'. I was then dismissed from the room. My GP showed me the letter he was sent afterwards advising that I am a 'non-compliant' patient. I think a lot depends on how the person in charge of the appointment manages it.

Suvi8901 profile image
Suvi8901 in reply to StormySky

” I have no idea who they were. The consultant started by enthusiastically telling me I will never get better and that things will only get worse whilst smiling at me. ..”

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What a dreadfully insensitive person!

Sorry to hear this.

Such an unprofessional team of people.

Hopeless bunch.

Sashappy profile image
Sashappy

I understand you completely as I've experienced this myself. If you feel uncomfortable about students in the room notify the nurse before you enter the room. I use to be very uncomfortable like you especially being shy when I was younger. As I have got older and have more medical problems I am not so bothered about additional people/students in the room anymore. I want them to know more about my medical conditions so they can work towards helping other patients when they are sitting in the doctors/consultants chair one day 🙂 Do what is right for you.

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