rock
Forum Elite
Topics: 23
Posts: 305
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hi guyz, another quick question
while we are examining the patient, do we have to tell him any finding or say aloud any findings. for instance, when i am inspecting the abdomen, do i have to say- no masses, no scars, no visible superficial veins, no masses on coughing etc...
or we just need to stare at the abdomen ?? which, by the way, would not look so polite...so what do we do at the time of inspection?
thanks in advance.
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| rock
Forum Elite
Topics: 23
Posts: 305
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or we could just say that "i am inspecting your abd for any masses or superficial veins"...is this ok?
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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Just inform them that you are seeing for masses.....Don't say too many things since it will eat up your time--Just say "I am looking for any abnormalities"--That would fit for any examination:-)
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| retroviridae
Forum Guru
Topics: 29
Posts: 871
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yeah, almost all of them won't have findings anyway .... I still remember the non-smoker who smelt like smoke. I kept thinking it was a trick and kept asking him if he quit yesterday, was around other smokers. Finally, I just said, look, you smell of cigarettes. He smiled and said no, he doen't smoke. So it was a case in which he was supposed to say he didn't smoke, but in real life, that man must smoke like a chimeny!
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| rock
Forum Elite
Topics: 23
Posts: 305
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interesting anecdote retroviridae
thanks again sprint123...i'll just say that then. short and sweet
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| GLO MD
Forum Guru
Topics: 9
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Don't ever say your findings aloud!!! Just say I need to check on your lungs or your heart is that ok with you? and then when they say yes say: i'll be leading you every step of the wa with a smile. You don't have to be talking to the patient all the time when you do your PE. Ask permission tell them what you will check and what you need them to do so that you can do so. Use your time to concentrate on what you think are the differentials and labs you will order because believe me that you will know what the patient probably has by just the history part, also if you forgot to ask something and suddently remember you may do so during physical. When you finish your PE and sit down again with the patient you may talk about what you think and what you found (althogh they are all healthy and beside simulated sign and symptoms you will not find much). BUT NEVER say I'm palpating a mass, I'm auscultating amurmur or whatever that you think you might be finding in your physicial.You will scare the patient off!!! Good luck!
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Keep your eyes on the stars, but remember to keep your feet on the ground....Theodore Roosevelt
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| AAzad
Forum Guru
Topics: 55
Posts: 456
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you have to say your findings to your patient , I think you can tell patient that I am going to need to examin your belly now , i am starting with listening to your belly after I finished with observation , is it ok with you. and then you have to tell him the findings , I am not sure why GLO MD says do not ever say your findings aloud.I agrree very much with all Glo MD sez but , I need to ask him why he think we shouldnot tell the patient the findings in the maner discused . Thank you
and
Good luck
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AAzad
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| GLO MD
Forum Guru
Topics: 9
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Oh!! =) I just ment that patients would scare off if while you are doing your PE you tell them that you are finding a mass, a collapsed lung or a murmur that they didn't know they had before and they may take it as rude or scare off. Is good to tell your patients your findings and in fact you have to do so!!!... but during your PE is not a very good idea. The best moment to tell your patient what you think might be going on with him/her or what you found during your PE or your history is during your closure and after your PE not during it. I think the average patient would totally scare off if while you are auscultating their lungs you tell them: "you have decreased breathing sounds on your left lung field mr so and so I think you have pneumonia!!!" jijijiji So the best moment again to give this findings or news are during your closure. Again, that is only my opinion and what has worked for me or what I've seen with most physicians, it does not mean is the best option. But I say, stick to asking for permission and letting the patient know what you are doing to him during your PE (ie listening to your belly, listening to your heart) and leave the details for later and after you have the chance to softening them for the patient.
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Keep your eyes on the stars, but remember to keep your feet on the ground....Theodore Roosevelt
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