Ask The Doctor: Free Medical Advice Blog

A medical consultation is a consultation which takes place between an employee and a licensed physician for the purpose of determining what medical examinations or procedures, if any, are appropriate in cases where a significant exposure to a hazardous chemical may have taken place. Medical consultation is important because it is the main opportunity for the doctor to explore the patient’s problems and concerns and to start to identify the reasons for their ill health. Traditionally, medical history-taking has been based on a conventional medical model and assumed that disease can be fully accounted for by deviations from normal biological function. It gave little consideration for the social, psychological and behavioral dimensions of illness.

Medical consultation starts by preparing for the consultation. You should plan for an optimal setting in which to conduct the interview. In general practice or in the outpatient department, the consulting room should be quiet and free from interruptions. Patients often find that the clinical setting stokes up anxiety and thought should be given to making the environment welcoming and relaxing. For example, arrange the patient’s seat close to yours, rather than confronting them across a desk. Hospital wards can be busy and noisy, and it may be difficult to prevent your consultation being overheard and maintain confidentiality. If possible, therefore, try and find a quiet room in which to talk to the patient. If you consult with a patient at the bedside, sit in a chair alongside the bed, not on the bed, and ensure the is comfortable and able to engage with you without straining.

It is important to establish rapport and put the patient at ease in first meeting with a patient . It’s a chance for you to demonstrate from the outset your respect, interest and concern for them. You should greet the patient, introduce yourself and clarify your role, giving the patient an outline of what your intentions are. It may sometimes be appropriate to give an idea of how long the interview might take. Communication consists not only of verbal discourse but also includes body language, especially facial expression and eye contact. The first contact should also be used to obtain or confirm the patient’s name and to check how they prefer to be called. Some people like to be addressed by their first name, while the others may prefer the use of their surname.

Next, identify the problems and concerns. Begin by asking the patient to outline their problems and concerns by using an open-ended question (e.g. ‘Tell me, what has brought you to the doctor today?’). Open-ended questions are designed to introduce an area of enquiry but allow the patient opportunity to answer in their own way and shape the content of their response. Closed questions require a specific ‘yes’ or ‘no’ response. Remember that patients often have more than one concern they wish to raise and discuss. The order of their problems may not relate to their importance from either the patient’s or doctor’s perspective. It is therefore particularly important in this opening phase not to interrupt the patient as this might inhibit the disclosure of important information. Research has shown that doctors often fail to allow patients to complete their opening statements uninterrupted and yet, when allowed to proceed without interruption, most people do so in less then 60 seconds.

Once the problems have been identified, it is worth reflecting on whether you have understood the patient correctly; this can be achieved by repeating a summary back to them. It is also good practice to check for additional concerns: ‘Is there anything else you would like to discuss?’ You may write down a summary of the patient’s comments, but constantly maintain eye contact and avoid becoming too immersed in writing (or using a computer keyboard).