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Old 04-28-2015
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Default When to counsel

I've already sat for my exam. When I encountered a patient that needed counseling on alcohol, tobacco, recreational drugs or unprotected sex, I did it immediately. This is because I almost always don't remember if I wait till the closure. Do you think this was a mistake or is it the same?? Thanks.
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Old 04-28-2015
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The best way I find is to counsel at the time it is brought up, but when I'm wrapping up an encounter and I always re-visit the items requiring counselling just to be sure I get those points from the SP.
Good luck.
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Volkmann (04-28-2015)
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Old 05-02-2015
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Quote:
Originally Posted by Volkmann View Post
I've already sat for my exam. When I encountered a patient that needed counseling on alcohol, tobacco, recreational drugs or unprotected sex, I did it immediately. This is because I almost always don't remember if I wait till the closure. Do you think this was a mistake or is it the same?? Thanks.
This is what I did as well and I think that is the best thing to do.

I ended up passing even though I was late on my closure in 3 cases (so I didn't have time in these cases to ask the patients if they had any more questions for me) and on a 4th case I had 20 seconds to answer a patient's challenging question and I answered it completely wrong!

I still passed the CIS component with above borderline performance (only a few stars on borderline area)

I think what made up for my points in CIS is that I always took my time to counsel as soon as a patient brought something up.
Whether it was smoking, alcohol, recreational drug use, increased stress, lifestyle modification, depression, or use of alternative or herbal medicine, I would always talk about that on the spot.

I think the cases where I was late on my closure I had to address many of these things during the encounter and that's why I was late. In retrospect, I would not cut any of these counseling advice short (even though they took a lot of time) and instead I would make my physical exam and history taking a bit shorter in these cases.
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