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  #1  
Old 05-19-2013
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Default Doubt about Counseling the patient?

While counseling the patient, can I tell the patient "Mr.__, my initial impression is that you may have __ or __. To confirm your diagnosis I'd like to run a few blood/urine tests and do an abdominal/chest scan "
or should I explicitly tell the patient what "EXACT" test/scan I'm planning on doing - for ex: "I'd like to do a blood test for the enzymes from your gall bladder and an USG of your gall bladder and X-ray of your abdomen" ?

I'd really appreciate if someone can clarify this for me.
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Old 05-19-2013
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Default Counselling

Your generic response would be to outline the next step in the management of the patient. Which would include, but not limited to, listing out your impression and then work up that you are going to do.
In some cases you are sure of the diagnosis and so you will be comfortable listing out the specific tests that you are going to do (it helps you remember when you are typing the patient note).
But sometimes if you are not sure of the differential then it would be safe to quote your statement "Mr.__, my initial impression is that you may have __ or __. To confirm your diagnosis I'd like to run a few blood/urine tests and do an abdominal/chest scan "
Also remember that if you mention a test , offer the information about the test as it will be counted towards information sharing with the SP.
Hope that answers your question!
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Old 05-20-2013
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Quote:
Originally Posted by drabdulkhadeer View Post
Your generic response would be to outline the next step in the management of the patient. Which would include, but not limited to, listing out your impression and then work up that you are going to do.
In some cases you are sure of the diagnosis and so you will be comfortable listing out the specific tests that you are going to do (it helps you remember when you are typing the patient note).
But sometimes if you are not sure of the differential then it would be safe to quote your statement "Mr.__, my initial impression is that you may have __ or __. To confirm your diagnosis I'd like to run a few blood/urine tests and do an abdominal/chest scan "
Also remember that if you mention a test , offer the information about the test as it will be counted towards information sharing with the SP.
Hope that answers your question!

Thanks alot!That definitely helped I have another follow-up question though. Do you think it's ok to counsel the patient after the History taking but before the PE? I was thinking this approach will ensure that I don't run out of time for the counseling bit. Any thoughts? Or is is mandatory to do it at the very end?
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Old 05-20-2013
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Default counsel at the end

to answer you question about whether to counsel between history and pe , I would suggest that you try to counsel in the end because that will give an impression of an organized thought process to the SP.
Try to use transition phrases a lot when you are moving from the history to the Pe and if you feel that you are running out of time or the history is taking a lot of time then start doing the physical and you can still ask questions while examining the sp
Make sure that you are able to complete the history by 8-9 mins so when the 10 min announcement is made you are in the middle of the pe that will ensure that you always have about 2-3 mins for your concelling
Hope that answers your question.
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Old 05-20-2013
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Quote:
Originally Posted by drabdulkhadeer View Post
to answer you question about whether to counsel between history and pe , I would suggest that you try to counsel in the end because that will give an impression of an organized thought process to the SP.
Try to use transition phrases a lot when you are moving from the history to the Pe and if you feel that you are running out of time or the history is taking a lot of time then start doing the physical and you can still ask questions while examining the sp
Make sure that you are able to complete the history by 8-9 mins so when the 10 min announcement is made you are in the middle of the pe that will ensure that you always have about 2-3 mins for your concelling
Hope that answers your question.
Thank you so much for the suggestion. I'll practice asking questions while examining.
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