"Doctor and patient communication skills"

About: Forth Valley Royal Hospital / Women's outpatient clinics and investigations

(as the patient),

I was referred by my GP to visit Larbert at the fertility child and mother department. I received a letter with no information about procedures, so I thought that I was just going to speak to the specialist. I was quite taken aback when I arrived and was sitting with a nurse filling out a questionnaire that she informed me that I would receive an internal examination as well as an internal scan. I have had this examination in the past and have always been informed of what will take place on my visit.

When you think you are just going for a chat and then you receive an internal examination, I would prefer to be mentally prepared, However I was embarrassed and became quite agitated. The worst part though was being sent into a room where the examination was to take place and was carried out by the nurse and not the specialist.

The doctor was present at this examination but did not introduce themselves and only became involved when the nurse needed guidance with the examination. They then started chatting behind the curtain and the doctor left the room. What was said to the nurse was then repeated to me. I appreciate that nurses have to be trained but when I receive a appointment to see a specialist doctor and they are present at the examination, I like to be introduced before any procedure takes place. I feel the doctor should be the one to give me my results but they left the room and was standing outside. The specialist only returned to the room on my leaving.

This was a humiliating experience and I felt the doctor was extremely rude. When we are referred to a specialist by our GP, it is for a reason and as a patient I was already worried and slightly stressed as to the results or findings. What we don't need is to feel even more stressed and taken out of our comfort zone by a rude and unprofessional doctor who seemingly has no doctor and patient communication skills.

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Response from Arlian Mallis, Person Centred Health and Care Co-ordinator, Department of Nursing, NHS Forth Valley We are preparing to make a change

Hi, I have been discussing your posting with the fertility team, there are a number of things that we can take and improve on. We will look at the letters that are sent out to patients and review the content.

Communication is always something we try to influence, a number of training programmes are available in Forth Valley we encourage all members of staff to attend.

It would appear that the person you thought was the Doctor was in fact a trainee, however this information should have been shared with you. This would be the reason that your examination was undertaken by a Specialist nurse. I'm sure this appointment was very important to you and we apologise that it made you feel stressed and out of your comfort zone.

I I have asked the fertility team to consider using your posting for learning, and I would like to use it in some of our communication training, so thanks for sharing.

I hope all goes well for you in the future.


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Update posted by Jinty (the patient)

Thank you for your response however you have confused me!! Firstly, upon my visit I was taken into a room with the nurse who introduced herself and we both sat and filled in a questionnaire. I was told that I would be going into the room next door and that I would be seen by a Dr.

The nurse checked if the doctor was available and then asked me to sit in the waiting area until I was called. The nurse then came to waiting area and took me to the room where the examination was to take place. I was asked to strip from the waist down and lay on the bed. During the examination the Dr appeared and told the nurse to carry out the procedure. At no point did the doctor introduce himself, stood in the background and then guided the nurse's hand when they were not pointing the object in the direction of my ovaries to see if they were producing eggs. The doctor was also explaining to the nurse what was on the screen.

Then they both went behind a curtain and the doctor explained the findings to the nurse and what to say. Once I got dressed the nurse asked me if I heard what the Dr said. I did hear what the doctor said but I wanted to hear it again face to face and not behind a curtain. So I said no. The nurse repeated word for word what the Doctor said.

So your response confuses me. I appreciate that this site is used for patients experiences and towards ongoing training, however what good is that when in response I feel like you do not listen to what we as patients have to say and that upon your investigation it sounds like to were speaking to someone who wasn't even present at the examination, or you are trying to insult my intelligence by thinking I am unable to identify an experienced doctor to a trainee.

If this site is being used for training purposes then why is my response back to you not shown for others to see and in confidentiality? Why is this? How many other patients have had a response like mine and does not make any sense and is not shown on the site because it is done in confidentiality?

Which leaves me to believe that this site is being used only to recognise positive feedback because it certainly has not cleared anything up for me, and your investigation of my experience will not help towards any future mishaps because you are not listening to us anyway?

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