Last week was our first introduction to clinical placement in general practice. I’m happy to see there is such an emphasis on exposure to the clinical reality during the first semester. Although I’m in clinic on a daily basis, the clinical focus at uni adds purpose to learning the most basic sciences (over again).
I will admit I did not have the highest hopes for the first day of clinical placement, but I am happy to say I was positively surprised and impressed. Got a great run-down on clinical history taking and communication in general, and the supervisors made a good effort to make the experience worthwhile.
A couple of years ago I used to sigh at communication training. Funny how your perspective and interests change after a couple of years in practice. Although this experience was nothing new as such, you can always improve aspects of your communication. You realize the importance and clinical significance of being great at the basics.
Most present in my mind after last week:
Let the patient speak without interruption.
The majority will stop talking within 2 minutes anyway.
Do not type or look at the computer during history taking.
At all! If Magnus Carlsen (22 yrs old, highest ranked chess player in history) can win 10 chess games at once without looking at the boards, certainly you can learn to recall a patient history or two.
Invite the patient to share further concerns, if more than one.
This way you can decide what is most pressing to focus on during this consultation. Let the patient know what you will prioritize and why.
The real reason the patient is seeking your help is often not revealed until after some time, and often via subtle hints. Perhaps more often than a question of a diagnosis is fear, concern, desire to understand, embarrassment etc. What made the patient come see you today, not 2 weeks ago?