Starting the consultation

Before starting, make sure you are talking to the correct patient. Introduce yourself, as your patients should know who you are and what you do. If you are in training, tell them, as patients are usually eager to help. It helps to create a good impression if you appear to have prepared to see them. Look at the patient records and at any transfer or admission letters before the consultation. It is easier to give your patient your attention if you do not write notes during the consultation, but you may have to write some things, e.g. blood pressure readings or family trees, which are easily forgotten. If you are going to take notes let your patient know. Throughout this part of the chapter there are examples of a doctor and a patient talking with each other. These are only illustrations, not hard and fast rules. Remember that it is the principles of communication that are important. If you get the principles right, then the words you use will change depending on the situation. To begin with, here are a few ideas on how to get an interview going.
Good morning Mrs Jones, I have got the right person haven't I? I am Mr Brown. I
am a fourth year medical student. I've been asked if I could come and talk to you
and examine you as you have just come into the ward today. Is that OK?
It might take me 20-30 minutes if that is alright with you.
I would like you to tell me what has been happening and then I'll want to ask a few
questions and examine you.
I see that you can't really get out of bed so I am afraid we'll need to talk here. I'll
pull the screens round, but I'm sorry it is not that private, so if I ask you anything
that you don't want to tell me in case others hear then just say so.
Because I'll have to get quite a bit of information from you, I'll need to make a few
notes. I hope that is alright because I'll forget otherwise. Now if I am writing things
down it doesn't mean I'm not listening to you, I still will be.
Are you happy with all that?