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Ex-USMLE Forums Staff
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Discussion Starter · #1 ·
All of us know that we should be asking about smoking, alcohol, and illicit drugs in the social history.

One particular advice here is to counsel immediately if the SP told you that he/she is doing any of these.

Do not postpone counseling to closure as you'll likely forget to do it.

If the SP is happy with what he's doing then it's advisable to say "Mr. James, if you ever thought of quitting smoking/alcohol/drugs in the future please come back to me and am ready to help. We have an excellent program here in the hospital that can help you quit".

If the SP is willing to quit then you say "Mr. James, am glad that you are willing to quit. I can certainly help you with this. We have excellent tools here in the clinic that can help make this process easier for you. I'll arrange for you a follow up visit to kick start the quitting meanwhile I'll ask my assistant to hand you an information sheet about our program. Examinee: Is that OK with you? SP: Yes. Examinee: Great (with a smile)"

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