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Tips from the
Clinic
1. Opportunistic health education & health promotion:
When the patient
complaint is minor and very clear, safe the consultation time for health
education & health promotion. E.g. A child brought by his father complain of
cough & runny nose, do not miss the opportunity to talk to his father about his
growth & development, his vaccination a, his diet, hygiene and safety at home.
2. Direct suggestive questions or open ended questions:
When you ask a
patient about red flags (risk assessment) try to avoid direct questions and
suggestive questions, because these types of questions may give you misleading
information. To get more correct information try to use open ended questions
like "how" question, e.g. how is your weight or how is your mood or how is your
sleep, instead of asking did you loss weight? or do you feel low? or do you have
difficulty in sleeping?
E.g. A patient with
headache and you want to exclude brain tumor. You may ask him: how do you feel
when you wake up in the morning, instead of asking: is the headache worse in the
morning? Or ask how is your vision? Instead of asking: do you have blurred
vision?
3. The risk of jumping to conclusion
However the context
of the consultation is pointed to a certain diagnosis, always try to react with
open mind, and think of possible differential diagnosis, otherwise you will jump
to wrong conclusion, and you may miss serious and important diagnosis.
E.g. If a 40-year
diabetic lady came with vaginal discharge, there is a great possibility the
diagnosis is Candida infection, but there is also possibility that it could be
anything from physiological discharge to cancer. So don't jump to conclusion
4. Everything is possible
When a patient comes with
unexpected complaint incompatible with his/her age or his/her status, try to
maximize your imagination and think of all possibility without inhibition. E.g.
a single respected lady came with migratory arthritis and skin rash, you can't
exclude possibility of Gonococcal septic arthritis just because she said she is
single and she looks respectable
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