Bad consultation example 2

Summary

In this consultation, a patient discusses her escalating anxiety due to life changes, including working full-time, her child leaving for university, and an online course. She previously found relief from Valium but is hesitant about pursuing cognitive behavioral therapy (CBT) as recommended by her healthcare provider, who cites new guidelines aimed at avoiding medication dependency. The provider offers a limited supply of tablets for immediate relief while arranging a referral for CBT. The conversation also touches on updating medical records, highlighting the importance of comprehensive care amidst the patient's current struggles.

Takeaways

• 😀 The patient is experiencing anxiety due to multiple stressors, including work, managing a household, and a child leaving for university.
• 😀 The patient previously received medication (Volum) for anxiety, which they found helpful.
• 😀 The healthcare provider acknowledges the patient's past treatment but emphasizes updated guidelines favoring therapy over medication.
• 😀 Cognitive Behavioral Therapy (CBT) is recommended as a long-term solution for managing anxiety.
• 😀 The patient expresses frustration over the lack of immediate medication and feels overwhelmed by the idea of therapy sessions.
• 😀 Sleep disturbances are a significant concern for the patient, who often wakes up early and struggles to fall back asleep.
• 😀 The patient admits to consuming alcohol (two small glasses of wine) at night to help with sleep.
• 😀 The provider suggests a compromise by offering a few tablets for short-term relief while the patient waits for a referral to CBT.
• 😀 The healthcare provider encourages routine health checks, such as blood pressure and cervical screening, to keep medical records up to date.
• 😀 The interaction highlights the tension between patient preferences for medication and the provider's adherence to updated treatment protocols.

Q & A

What is the main issue the patient is facing?

The patient is experiencing anxiety due to various life changes, including her child going to university, her husband being abroad, and balancing a full-time job with an online course.

What previous treatment did the patient receive for her anxiety?

Two years ago, the patient was prescribed medication, specifically Valium, which helped her manage her anxiety at that time.

Why does the doctor suggest Cognitive Behavioral Therapy (CBT) instead of medication?

The doctor recommends CBT as a more effective long-term solution based on updated guidelines, emphasizing that it addresses the underlying issues of anxiety rather than just the symptoms.

How does the patient feel about the suggestion of therapy?

The patient is hesitant about therapy due to her busy schedule and prefers medication because it worked for her in the past.

What are the doctor's concerns about prescribing medication?

The doctor is concerned about the potential for addiction to the medication and emphasizes the importance of exploring alternative options for managing anxiety.

What lifestyle factors does the patient mention that may contribute to her anxiety?

The patient mentions difficulty sleeping, feeling overwhelmed with responsibilities, and having a few glasses of wine at night to help her sleep.

What follow-up actions does the doctor propose for the patient?

The doctor suggests referring the patient for CBT while providing a small supply of medication to help her temporarily, and also recommends making appointments for necessary health checks.

How long does the doctor say it typically takes to get an appointment for CBT?

The doctor mentions that it usually takes about a month to be seen for CBT after a referral.

What health checks does the doctor want to ensure are up to date?

The doctor discusses the importance of ensuring that the patient's smear test and blood pressure checks are up to date.

How does the patient describe her current state of mind?

The patient describes feeling tearful, unmotivated, and anxious, expressing that she feels overwhelmed by her current circumstances.