01 Jan Discuss the patient population your preceptor works with How do the patients find this doctor?
Topic: Clinical Observations Order Description you can pick one or 2 questions. the first page of the pdf just explains what we should do and observe at the clinic,we should observe one patient and take her/his medical history. the patient you observed was a 37 years old female. she was obese and her chief complaint is abdominal pain on her left side. during physical examination, enlargement of the abdomen when the doctor touched it or when the patient coughed, so probably hernia. and for the past history, she had pituitary tumor (affected her memory somehow, she was acting weird) also adrenalectomy was done on her, her adrenal gland was removed. also, she was in a coma for a week (probably adrenal crisis). for the family history, her mum died two years ago of cancer, and her uncle also has hepatic cancer. when taking the history, she was talking a lot she said everything and about her family without even asking. she was talkative. so in the essay, you can relate what you observed with the questions that should be answered for the essay. Eliciting Medical History At your preceptor: ? Discuss topic of last week?s Medical History lecture and goals for preceptor session. How does your doctor interact with the medical center? Is it a group or solo practice? Who is part of the team? Does your preceptor also see inpatients? ? Discuss the patient population your preceptor works with. How do the patients find this doctor? ? Ask your office preceptor (OP) to identify one or more patients who you may interview today . Interview patient and document in Clinical Record : ? Elicit one patient?s demographic information (i.e. age) and reason for office visit/chief complaint. ? Elicit an HPI. Focus on getting a past medical history (PMH) from the patient. Be sure to get pertinent negative history items (e.g. no past history of cancer, diabetes, or surgery.) Inquire about medications (look these up and use generic name) and allergic reactions to medications or foods (list the allergic reaction that occurred). ? Practice taking vital signs. If feasible within the flow of the office, take height, weight, waist circumference, and calculate BMI on one patient. ? Document your interview as a formal write-up. Observe doctor- patient interaction: ? In each medical encounter, observe which components of the interview the physician elicits and in what order. ? Observe how your OP thinks and inquires about patients? problems. ? How are the patients educated about their health (e.g. giving information, counseling, instruction)? If nurses or other professionals are involved with this process, try to observe them in the office setting. ? How does the physician elicit the HPI & PMH? Note balance of doctor-centered and patient ? centered questions. Debrief/Discussion : ? Discuss how your OP organizes his/her history- building. Why does s/he ask the questions s/he does? In what ways does s/he use clinical reasoning skills to elicit the patient?s history? ? How does your Office Preceptor make decisions abo ut insurance plans they accept? Does your OP believe health care quality is affected by the patient?s insurance status? Medicine, Patients and Society I Clinical Observations Office Preceptor Session 1.3 October 22, 2014 Eliciting Patient?s Story Choose one or two of the following questions and post your response to your Clinical Observation Submissions Folder on Canvas : ? What aspects of the interview are you finding easier to do? Which are more difficult? ? What possible strategies can be used to address these challenges? ? How does your OP ?reason? through complicated cases? ? Have you been able to identify his/her strategies? ? Communication can occur both verbally and non -verbally. List one more examples of how communication occurred non -verbally in the office today. What was communicated? How was it communicated? ? How do you stay organized in taking a Past Medical History? ? How have your patients responded to being interviewed by a medical student? PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET AN AMAZING DISCOUNT
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