"Upset by doctor in the CAU at Forth Valley"

About: Forth Valley Royal Hospital / Acute assessment unit Forth Valley Royal Hospital / Clinical assessment unit

(as the patient),

In March I was sent by the out of hours service to the CAU due to stomach pain and fainting. While there, and in AAU3, I received excellent care from nurses and nursing assistants.

I was seen by a doctor however who really upset me. Having (I assume) looked at my notes, when he was speaking to me, he said, "eating disorder? You aren’t very slim”. Feeling as ill as I did I didn’t say anything to him about the inappropriateness of the comment, but after he left I was really upset and crying – the nurses were again excellent and understood why I was upset.

I asked not to see that doctor again and was told I wouldn’t. The next day though he came back to see me, despite me saying again in the morning to a junior doctor that I really didn’t want to see that doctor, and this time his comment regarding my eating disordered history was that I looked fine so my diet must be fine. I started crying when he said it this time. The junior doctor was with him, and they both left but the junior doctor came back to check I was ok and apologise. Luckily I didn’t see him again.

It perhaps isn’t clear, but in my opinion not all – in fact relatively few – people with eating disorders or a history of an eating disorder are significantly underweight. Most will be a normal weight, some might even be overweight. Not being visibly underweight does not mean you don’t have an eating disorder, and I believe it is exactly those kind of inaccurate perceptions that stop people with eating disorders seeking help. I don't think doctors should be reinforcing these perceptions with comments like the one made to me. Though the comments upset me, I know that the doctor was wrong in what he said, which makes me wonder if he told me anything else that was incorrect that I didn’t pick up on – my confidence in his ability as a doctor, someone who should be trusted, is reduced.

I’d like reassurance about the professional development of consultants in Forth Valley and what it covers – does it cover mental illnesses like eating disorders? I’d also like to appeal to junior doctors and nurses to be brave and say something at the time of an inappropriate remark or comment – not just come back and apologise later. I appreciate it is difficult and not currently the norm, but no one should be letting patients believe things they know not to be correct.

Again I’d like to commend the hard working nurses in this area of the hospital, they make a painful, scary and upsetting experience much more bearable through their compassion, good humour and care.

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Response from Arlian Mallis, Person Centred Health and Care Co-ordinator, Department of Nursing, NHS Forth Valley

Thanks for taking the time to let us know about your experience of care. I'm sorry that the comments made to you were so upsetting. You have made some very valid points which I would like to share with the team. I would also like them to respond to your posting as I don't have the detail of educational developments etc. I will forward your posting and ask for a response.

Many thanks


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Response from Arlian Mallis, Person Centred Health and Care Co-ordinator, Department of Nursing, NHS Forth Valley

Thanks very much for your feedback we have shared your story with the team and would like to apologise that your experience of care from the doctor was upsetting for you. We are keen to learn from feedback so that we can address issues that are raised such as communication as you have highlighted. In relation to the professional development of Consultants - they undertake a standardised approach of appraisal and revalidation. however this will not cover specifically eating disorders. There is a process for all Consultants to undergo regular appraisal.

In relation to staff speaking up we actively encourage staff to speak up and challenge behaviours, although as you have said this is often difficult.

Your story has been shared with our senior medical staff who are ensuring that Doctors of all levels attend communication training.

I would like to offer you the opportunity of speaking with me if you would like to share more detail, which would allow us to be more focused in relation to training about eating disorders.

you can contact my by email - arlian.mallis@nhs.net

or by telephone on 07827820353

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