Communication Skills: A Patient-Centered Approach

wmumed

9 Jul 201513:18

Summary

TLDRIn this medical role-play transcript, a patient named Bellamy visits a doctor due to a severe headache that started three days ago and has not improved with common pain medications. The headache is constant, worsens with movement and light, and has affected Bellamy's daily life, preventing work attendance. The patient expresses concern about insurance coverage after recently changing insurance companies. The doctor, Harris, addresses Bellamy's worries, plans to check insurance details, and proceeds to gather a detailed medical history, including family history of migraines and the patient's smoking habit. The encounter ends with feedback from the standardized patient, commending the doctor's communication skills and providing suggestions for improvement.

Takeaways

😀 The patient, referred to as 'mom', is visiting the doctor due to a severe headache that has been persistent for three days.
🤔 The patient is concerned about insurance coverage since she recently changed insurance companies.
🏥 The doctor plans to look into the patient's insurance policy to ensure everything is in order while conducting the patient's history and physical examination.
😣 The headache is described as a 10 out of 10 in pain severity, affecting the entire head and causing nausea and vomiting.
🚫 The patient has tried Tylenol and Motrin without any relief from the headache.
🔍 The doctor is considering the patient's medical history, including controlled high blood pressure, and family history of migraines.
🚭 The patient smokes about half a pack of cigarettes a day but does not consume alcohol.
👨‍👩‍👧 The patient is married with no children and is currently in menopause.
🧳 The patient recently traveled to North Carolina for a family reunion where she was in contact with a sick four-year-old.
🤕 The headache worsened with movement and light, and there was also a shooting pain down the neck and a stiff neck.
📝 The doctor intends to complete a physical exam and perform some tests after discussing the patient's history and concerns.

Q & A

What is the main reason for Miss Bellamy's visit to the doctor?
-Miss Bellamy is visiting the doctor due to a severe headache that started three days ago and has not improved despite taking over-the-counter medications.
What concerns does Miss Bellamy express about her insurance coverage?
-Miss Bellamy is concerned that her recent change in insurance companies might not cover the visit, and she wants to ensure that the treatment will be covered.
What is the doctor's approach to addressing Miss Bellamy's insurance concerns?
-The doctor plans to have the office secretary look into the insurance plan details while they proceed with the history and physical examination.
How does Miss Bellamy describe the onset and progression of her headache?
-The headache started gradually three days ago and has remained constant without getting better or worse. It is a 10 out of 10 in terms of pain severity.
What factors seem to aggravate Miss Bellamy's headache?
-The headache is worsened by movement and light, and it is causing her to avoid moving and is very bothersome when exposed to light.
What is the nature of the pain Miss Bellamy is experiencing?
-The pain is described as constant, all over the head, and accompanied by a stiff neck and shooting pain down her neck.
What is Miss Bellamy's medical history relevant to her current condition?
-Miss Bellamy has a history of high blood pressure, which has been well-controlled through diet changes and monitoring without medication.
Does Miss Bellamy have any family history of similar conditions?
-Her mother had migraines when she was younger, but there is no other significant family history of headaches or other related conditions.
What lifestyle habits does Miss Bellamy have that could be relevant to her condition?
-Miss Bellamy smokes about half a pack of cigarettes a day but does not drink alcohol.
What recent event in Miss Bellamy's life could potentially be related to her symptoms?
-Miss Bellamy traveled to North Carolina for a family reunion two weeks ago, where she was around a sick four-year-old, although the specifics of the illness are unknown.
How does the doctor plan to proceed with the examination and testing after taking the history?
-The doctor plans to complete a physical examination and perform some tests to determine the cause of the headache.

Outlines

00:00

🤕 Consultation for Severe Headache

The patient, referred to as 'mom', visits the doctor due to a severe headache that started three days prior and has not subsided despite taking over-the-counter medications. The pain is constant, all over the head, and is exacerbated by movement and light. The patient expresses concern about her insurance coverage after recently changing insurance companies. The doctor reassures the patient and plans to check the insurance policy details while conducting a physical examination to determine the cause of the headache.

05:00

📝 Medical and Social History Assessment

The patient has a history of well-controlled high blood pressure managed through diet changes. There is no surgical history or hospitalizations. The patient's mother had migraines in her younger years, but there is no other significant family medical history. The patient smokes about half a pack of cigarettes daily but does not drink alcohol. She is married with no children and is currently in menopause. The patient also mentions a recent trip to North Carolina for a family reunion where she was in contact with a sick four-year-old child. The doctor plans to conduct a physical examination and asks if there are any other concerns before proceeding.

10:02

🗣️ Feedback on Communication Skills

The standardized patient, 'Deb', provides feedback on the doctor's communication skills during the consultation. She commends the doctor for a warm demeanor and effective introduction, setting a clear agenda, and actively listening to the patient's concerns. The doctor used open-ended questions to encourage the patient to share her story and followed up with pointed questions for clarification. The feedback highlights the importance of reflective listening and signposting between sections of the interview to ensure the patient is well-informed about the consultation process. The doctor is encouraged to use reflective listening to confirm understanding and to be mindful of personal questions by introducing them sensitively.

Mindmap

Keywords

💡Headache

Headache refers to a persistent pain in the head, which is the primary complaint in the video's script. It is a common symptom that can be caused by various factors and is central to the patient's visit to the doctor. In the script, the patient describes her headache as severe, constant, and affecting her ability to work and function normally.

💡Insurance

Insurance in this context refers to health insurance, which is a concern for the patient as she has recently changed insurance companies and is unsure whether her visit will be covered. The doctor addresses this concern by assuring the patient that the office secretary will look into the insurance plan details, showing the importance of financial considerations in healthcare.

💡Clinical Problem

A clinical problem refers to a medical issue or condition that requires professional medical attention. In the script, the patient's clinical problem is her severe headache. The term is used by the doctor to inquire if there are any other issues the patient wants to address, indicating the comprehensive approach to patient care.

💡Physical Exam

A physical exam is a routine procedure performed by doctors to assess a patient's health by examining various body systems. In the video script, the doctor plans to conduct a physical exam to further investigate the cause of the patient's headache, which is a standard practice in diagnosing and managing clinical problems.

💡High Blood Pressure

High blood pressure, also known as hypertension, is a medical condition where the force of the blood against the artery walls is consistently too high. The patient in the script has a history of high blood pressure, which is a relevant piece of her medical history that could potentially be related to her current headache.

💡Migraine

Migraine is a specific type of headache characterized by severe, often debilitating pain, typically on one side of the head. The patient mentions that her mother used to get migraines, suggesting a possible genetic predisposition to the condition, which could be relevant to the patient's current headache.

💡Seizures

Seizures are sudden, uncontrolled electrical disturbances in the brain that can cause changes in behavior, movements, feelings, and consciousness. The patient expresses concern about having a brain tumor after hearing about a neighbor who had a headache, ignored it, and later had seizures, indicating a fear of serious neurological conditions.

💡Smoking

Smoking is the act of inhaling and exhaling the smoke of tobacco or other substances. The patient admits to smoking half a pack a day, which is a significant lifestyle factor that can impact health and is often discussed during medical consultations due to its association with various health risks.

💡Menopause

Menopause is the natural cessation of a woman's menstrual cycle, marking the end of her reproductive years. The patient mentions being in menopause, which is a part of her gynecological history and could have implications for her overall health and the symptoms she is experiencing.

💡Family Reunion

A family reunion is a social gathering of family members, often occurring on special occasions or holidays. The patient mentions attending a family reunion in North Carolina a week ago, which is a part of her recent history that could potentially provide context for her current health condition.

💡Emergency

Emergency refers to a situation requiring immediate action or attention due to a severe injury, illness, or other urgent matter. The patient recalls a four-year-old being taken to the emergency room during the family reunion, which could be relevant to the patient's concern about her own health and the urgency of her symptoms.

Highlights

Patient presents with severe headache for three days, impacting daily life and work.

Headache described as constant, all over the head, with pain radiating to the neck and causing stiffness.

Patient rates pain as a 10 out of 10, indicating extreme severity.

Headache is aggravated by movement and light, prompting concern for potential serious conditions.

Patient has no relief from over-the-counter medications like Tylenol and Motrin.

Patient expresses concern about insurance coverage due to recent change in insurance companies.

Doctor reassures patient that the office will check on insurance coverage while conducting the examination.

Patient has a history of high blood pressure controlled by diet.

Family history includes mother's past migraines and father's high blood pressure.

Patient smokes half a pack of cigarettes daily but does not consume alcohol.

Patient recently traveled to North Carolina for a family reunion.

Patient reports being around a sick four-year-old during the reunion, raising concerns about possible infection.

Doctor plans to conduct a physical exam and tests to determine the cause of the headache.

Patient expresses fear of having a brain tumor due to a friend's experience.

Doctor provides feedback on the medical student's communication skills, highlighting areas for improvement.

Feedback includes suggestions for more reflective listening and clearer signposting during the consultation.

Doctor commends the student's warm demeanor and active listening skills, contributing to a comfortable patient experience.