‘Not how they actually feel’

and relatively often

Not why

Even the term, let alone the instruction, to be

‘Listening with empathy’

conveys so much about what can be wrong about performative listening

Certainly, sometimes, defensive environment can mean eg

'Do it once, do it right'

comes to be more case of

'Don't do it at all, and hope someone else will'

This can come to be very very far from being in best interests of the patient (in any direction)

NHS and Private

By time a patient is repeatedly not heard and/or misrepresented in what actually describing there can be so many other ways of bringing about harmful situations for them

(And my goodness 'Do No Harm' can come to be almost weaponised in a defensive environment)

(NHS and Private)

And defensive environment can come to mean stated ‘best interests’ and actual best interests of patients not always the same thing

(Any clinician)

(NHS and Private)

And, at same time, patients can come to be 'treated' for what are, certainly, not the symptoms

There cannot helpfully and simultaneously be 'a need to act in the face of uncertainty' and a System which does not acknowledge the existence and reality of uncertainty

It is a lot to ask

But, at the same time, the absence of these aspects can mean a terrible experience for patients

'System' can need to enable

NHS and Private

Tim Ricketts For me a doctor, first and foremost, is the one person who puts the patient's needs first. This might be stating the obvious but not sure it happens often enough. Patients' needs are changing and I'm not sure professions are adapting quick enough.

Tim Ricketts Decide. Act in the face of uncertainty. Hold risk. Be present. Lead.

As always, some, even many, clinicians ‘do’ do this

But not being believed, as a patient, even about what the issue and pain is not, can be one of the most isolating, despair inducing predicaments

Widely recognised

But one that receives the least focus

NHS and Private

Patients’ concerns can be minimised

Patients’ actual concerns can be misrepresented

Routinely as well as in ‘incidents’

Where is the ‘duty of candour’ which states that clinicians ‘treated’ patient as if imagining the issue? Repeatedly

‘Everyday’ doesn’t make it ok

And to be honest if a clinician listens to the answer ‘and’ takes it seriously don’t much care about their style of asking the question

Tick list and tick list responses can mean two entirely different and unrelated ‘conversations’ are had

And please represent what patients are actually describing

As per earlier, the issue here is not abbreviations and medical terminology which are to be expected

Equally, in absence of belief and related action, patients can have unrelated tests done and have these and this almost held against them

Can't say too many times please include the patient

Please hear patient, including patient's usual and not

Please make patient input count

There is an encouraging and BIG difference, at least, in any area of healthcare provision, between saying (as clinician) eg

'we don't understand the mechanism via which X is happening' (and meaning this)

and saying

'X is not happening'

NHS and Private

Interesting to hear this said in context of Long Covid

Not come across many areas of healthcare where 'both doctors and patients 'worry' that their symptoms are 'all in their head''

'Often patients have had extensive testing even before they arrive, and far too often—when all the tests are normal—both doctors and patients worry that their symptoms are “all in their head.”

Certainly by time continuity lost, unrelated clinicians involved/actual symptoms not represented the patient can be only one to be making the whole journey

And yet be last to be heard even about what issue not

As always not in every instance

As always where case, NHS + Private