1st- Express your understanding for the SP's concern
2nd-Answer the question
3rd-Counsel/Reassure
4th-Ask if they have more questions
The basic idea to is to tell the SP that more diagnostic tests would be needed before one can be sure in most cases!!
Examples of challenging questions:
Q "Can you give me some antibiotics to help me get better?"
A "I understand your concern Mr Smith. Antibiotics work only when there is a bacterial infection. While your symptoms could be due to it, there are many other conditions which
can cause similar symptoms. I would surely prescribe you antibiotics if they are indicated. However for me to know if you need them, we need to run some tests first. If we find any evidence of bacterial infection, we will go ahead and take antibitics. Does that answer your question Mr Smith?"
Q "Do you think I will be able to use my leg again like before?
A "I understand your concern Mr. Smith. I am hoping that you will be able to use your leg like before, but to be sure, we need to confirm whether it's broken or dislocated and if there is any nerve or muscle damage. We will know once we run a few tests. Iwould then treat accordingly and try my best to preserve the function of your leg and make you comfortable."
Q "Do I have cancer, doctor?"
A "I understand your concern, Mr. Smith. We cannot exclude the possibility of cancer at this point. We need to perform additional tests. Once we have the results in, we will know for sure. Regardless of the results Mr. Smith, I want to assure you that we as a team would do the best we can to make you comfortable and address your concerns. Does that answer your question Mr Smith."
Q "Will I get better if I stop smoking?"
A "Mr Smith I totally understand your concern. I am glad that you are thinking about quitting smoking. Although we still have to find out exactly what's making you sick, stopping smoking should help your chronic cough. Overall it will also decrease the risk of cancer and heart disease. We have excellent smoking cessation counsellors that I can refer you to if you so wish." Does that answer your question?
Q "Doctor, am I going to die?
A "I understand your concern Mr Smith. Your condition may be serious, but until I get the test results back, we cannot be sure of the diagnosis. There are many disease that cause symptoms similar as yours. We will know the exact diagnosis only when we have the results. So please do not worry at this time. Now that you are here, we will do everything we can to help you".
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