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USMLE Step 2 CS Communication Skills Step 2 CS Communication, Spoken English Proficiency, Language and Interpersonal Skills Discussion forum. CIS and SEP components of the USMLE Step 2 CS Exam.


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  #1  
Old 03-08-2012
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Help Referral in counseling....

Hi all,

I have a question for u guys, if a patient asks about something we don't know its answer, for example a new device he has read/heard about.....can we just tell him "well, i don't know much about this issue, but I may read about it and tell you".

Another question guys....Can we tell the patient "I may refer you to a specialist for eg. surgeon or gynecologist...."
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  #2  
Old 03-08-2012
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Arrow Yes and No

Yes. Definitely you can tell the SP "I am not sure about this issue, let me consult my senior expert colleagues and I'll get back to you with an answer".

No. We don't usually need to refer SP to specialists. This is because in the CS encounter you try your best to reach a diagnosis and it's an initial primary encounter which ideally would be followed by a number of investigations and procedures.

If a diagnosis cannot be reached after all blood tests, investigations, imaging, procedures, ...etc only then a referral to a specialist is needed.

So never say "I will refer you to a specialist".

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  #3  
Old 03-13-2012
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Warning!

Ya but in FA there is a case about hearing loss and in the closure it is written that u should mention referring to an audiometrist to assess for hearing aid!
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Old 03-13-2012
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Originally Posted by liquidreams View Post
Ya but in FA there is a case about hearing loss and in the closure it is written that u should mention referring to an audiometrist to assess for hearing aid!
Sabio was talking about your general statement "I will refer you to specialist" in the context of history taking.

Referring to audiometry is not considered a consultation, you can consider it an investigation or an extra lab test that you want to perform after the encounter, just like Chest X Ray, blood tests, rectal exam, ...etc

However, you should not say for example, I will refer you to a surgeon in a patient with suspected appendicitis, because it's your job to diagnose the appendicitis.

Another example, you should not say I will refer you to the ENT specialist in a patient with ear problems because it's your job to find out what's wrong with the ear.

As Sabio said, only after all tests and labs, you did not come up with a treatment plan, only then you refer to specialist and such a scenario is not even possible in the context of the CS exam.

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Old 03-13-2012
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Help

Quote:
Originally Posted by StepTaker View Post
Sabio was talking about your general statement "I will refer you to specialist" in the context of history taking.

Referring to audiometry is not considered a consultation, you can consider it an investigation or an extra lab test that you want to perform after the encounter, just like Chest X Ray, blood tests, rectal exam, ...etc

However, you should not say for example, I will refer you to a surgeon in a patient with suspected appendicitis, because it's your job to diagnose the appendicitis.

Another example, you should not say I will refer you to the ENT specialist in a patient with ear problems because it's your job to find out what's wrong with the ear.


As Sabio said, only after all tests and labs, you did not come up with a treatment plan, only then you refer to specialist and such a scenario is not even possible in the context of the CS exam.

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ok but for example,a patient with vaginal discharge and is worried that her IUCD is causing it...can I tell her "I will refer u to a gynecologist to check it"?
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Old 03-13-2012
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ok but for example,a patient with vaginal discharge and is worried that her IUCD is causing it...can I tell her "I will refer u to a gynecologist to check it"?
No.
Say this;
Mrs. Smith, that may well be the reason, but in order to confirm the cause of your discharge, I need to do full vaginal/gynecologic examination. I will come back with my nurse and do vaginal examination after I go outside to write some orders.

then add vaginal/gynecologic examination to the diagnostic work up in your patient note.

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Old 03-13-2012
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Angry Are you ever going to say thank you

I can't believe it how this guy liquidstuff has no manners at all.

You helped him so far with his "s" questions and yet he has never said thank you to any of your posts.

I admire your patience StepTaker, I wish I was as cool as you are
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Old 03-13-2012
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Quote:
Originally Posted by StepTaker View Post
No.
Say this;
Mrs. Smith, that may well be the reason, but in order to confirm the cause of your discharge, I need to do full vaginal/gynecologic examination. I will come back with my nurse and do vaginal examination after I go outside to write some orders.

then add vaginal/gynecologic examination to the diagnostic work up in your patient note.

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Thank u alot step-taker....Im sry I just saw ur reply right now!
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