Originally Posted by XpaezX
It depends on personal preference. Both are correct ways of doing it. For example in my case i felt it was better to summarize + counsel + use PEARLS right after history / before PE while wearing gloves so that you dont miss any information or dont forget it later on (in case your memory sucks).
I think people that have yet to take the exam must practice and see which way they feel more comfortable with.
Yes, I think you are right. I just think it gets awkward and weird to do that. But not a deal breaker...as it is more important to ask rather than to ask at the right time.
I used PEARLS all through the encounter whenever I had a chance (like CSE doc)
I counseled right after the patient confessed that he was a smoker or an alcoholic, etc. - I believe these are things you can forget if you leave them to the end (like CSE doc)
But to me it seems natural to summarize the history at the end of history + PE, and then say - "based on this and the physical exam, I think you might have ____ or _____. I would like to do _____ or ______ tests. Is there anything else you would like to ask me at this time? No? I will see you with the test results, Mr. _____. Thanks"
Just my two cents.