How to start a consultation (part two)….

In part one we looked at patients who may be described as “poor historians” and give you very little idea as to their problem, part two looks at those patients who come in and have a more open approach to their consultation…

Sometimes it’s a case of….
“Well it all started in 1932 when…”

Max is interested, but could we perhaps start in this decade?

Sometimes, it’s a leading statement -

for example the 60 year old person, married for 40 years who sits down and abruptly declares “I want an AIDS test”.  You wiggle your bottom, get comfy and prepare to hear a true story, that even the best soap opera writers couldn’t have dreamt up….(and no I am not sharing this story with you!)

Today I was rattled.

 If you want to motivate your practitioner, don’t go in with a weak arguement and an agressive tone….

“I’ve had back pain for 10 years and when I come here nobody ever does anything about it!!”

Max, as previously stated is a detective…so I go for a rumage through the notes, this patient had complained of his back twice in 10 years, the last was yesterday, when he was sent for an Xray (results pending), and the time before when he was referred to Physio.  Not exactly the picture of medical neglect that he painted!

So I pointed out to him, what he meant was that he was having treatment and investigations for his back, but the over the counter medications were not adequate and he had failed to mention this to my colleauge the day before.  He quietened down and left with a script for some diclofenac.

Conclusion (for practitioners): Allow the story to unfold, sometimes it needs nuturing, sometimes it needs some editorial encouragement to shorten and sometimes it needs to be researched to ensure you’re not getting a load of Bull.

Conclusion (for patients): We are here to help, tell us what we need to know.  The fact Aunt Nora’s sisters cousins friends vet once had the same symptoms and consequently died at the age of 106,  is not relevant. You may have to sit in the waiting room prior to seeing us, why not take this opportunity to consider what you are going to say!

Well you be pleased to hear Max is having a week off. But I’ll be back…