a health care professional is talking with a female patient who is taking captopril This is a topic that many people are looking for. khurak.net is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, khurak.net would like to introduce to you Communication Skills: A Patient-Centered Approach. Following along are instructions in the video below:
Miss bellamy yes harris will be your doctor today when you just wash my hands hands really quick would you prefer miss bellamy or pats fine great once i say youll miss mom can you tell me why im here today. I have a terrible headache looks really bad um is there anything else besides your headache that you want to address here. Today to the clinical problem.
No its just that except i am concerned i just recently changed. Insurance companies and im not sure. This is going to be covered.
Yet um is there anything um. Because i what we can do is while were talking and undoing your history and physical. I will have my office secretary look into it the insurance plan in your gasps all right.
So you dont have to worry about that sounds good okay sounds. Great mom is there anything else no i just. This is just really bad okay.
So what id like to do today. And its lets lets take a look at whats causing your headache. I will go over history physical and then well do it again a physical exam.
And then we will look at your insurance policy and make sure thats all okay taking care is that some a bigger plan thats good perfect um. So tell me a little bit more about this the head pain. That youre having yeah well um.
It started about three days ago. And nothing has helped it its it just laid me flat. I havent been able to go to work its nothings helped i its its all over i it really bad when im oh.
Some try not to move. Too much and the light is bothering me a lot okay. Unfortunately.
I cant dim. The lights in this room. But so okay ill try to go quickly and would be okay.
If i took some notes sure all right so you said this headache started about three days again okay was there any anything that brought it on anything unusual. What happened maybe three days go really no okay can you tell me anything that makes it better well. Nothings made it better.
I took some tylenol motrin. Nothing. I just try not to move.
Too. Much. All right is there anything that makes it worse.
Yeah like movement. Welcome home and and light okay. And its just constant.
Though theres you know it doesnt its just constant. Its its all over okay so if you had a raid on a pain scale 0. Being no pain 10 being the worst pain youve ever had 210 thats how ive never had a headache like this okay.
Yeah. That sounds really bad now as far as radiation. Does that move does it that you said the head.
The pain is all at the front of your hands kind of all over okay um. But it also i got this shooting pain down my neck. And my neck is very stiff okay.
But its not its its its the entire head tiger head okay yeah as far as in the in the timing. You said that started three days ago music users are constant yeah. It it started gradually.
But once once it got there its it hasnt gone away it doesnt get better it doesnt get worse. Its just the same okay so do you what i want to get is your perception of what you think is going on. I just could hardly think its so painful i just um because its so bad.
I was afraid my neighbor had a headache and ignored it last year. And i suddenly started having seizures and it turns out. He had a a brain tumor.
So i thought i just should come in and yeah. I can understand your concern. What how is it impacting your daily life.
I cant go to work. I cant do anything yeah. So it sounds like its really impacting your life.
Yeah. I cant okay. Its okay.
I would like to go some talk about a little bit about your medical history yourself chancery all right can you tell me as far as your medical history have you have any medical conditions. I should be aware that not i was diagnosed with high blood pressure about three years ago. But weve been addressing it with diet changes and monitor yeah i go in yearly.
I had been just and its been well controlled. So okay i havent been on medications for that other than that i havent had any problems okay on any surgical history. Know any hospitalizations all right and you said youre the only medicine youre taking was telling all my training yeah and they didnt help yeah okay.
I just wanted to verify um. You have any drug allergies no okay what about family history. Do you have any medical history of headaches or my family right.
Oh you know my mom said she used to get migraines. When she was in her 20s and 30s okay. But i dont remember her say anything else about it my sister have one sister.
Shes shes healthy. My dad uh he has high blood pressure or other than that hes healthy and thats about it i dont i dont have any kids alright. Its alright.
I would like to ask you some social history questions that just for their records. Do you smoke. Yeah.
I do okay is it cigarettes or true. Yes. Okay.
I know how much do you smoke about a half a pack a day. Okay what about alcohol. I dont drink okay also are you married yeah.
Im married okay and children. No okay. And just uh.
Some just some additional questions is um looking at kind of gyn history. Are you last menstrual period. Im in menopause okay so going back into the history.
Again have you you said your mom had migraines earlier on have you been around and no. Other you havent been nauseous or have you been yeah. I bet.
Ive been nauseous a fact i threw up twice early on okay because when i move it makes me nauseous okay nothing out of the ordinary over the past couple weeks have you been on any trips or anything or actually a week ago. I was in north carolina for a family reunion. Okay.
And there was a four year old who was sick there i i dont know what they had but i guess i guess they ended up taking into emergency. So let me just summarize to make sure ive got everything straight. So far is you started an onset of a severe headache about three days ago.
Its worse with movement and light really makes it hurt bad. Its a 10 out of 10 pain and youre also complaining of a stiff neck with that yes. It came on gradually.
And its been constant pain in the frontal area medical history. Here on hyper you have high blood pressure. But thats control.
The diet. No surgical history. No really hospitalizations the pain.
No isnt really impacting your day to day living. In daily life. You took try to town on motrin.
It didnt help otherwise no medications. Youve got the family history of your mom. With migraines.
Otherwise. Your family is healthy. Yeah.
You smoke about a half a pack. A day. Do you dont drink and then you were you did you said you took a trip about a week ago yeah two weeks ago.
Yeah okay my reunion a weeks ago was in north carolina. All right um yeah i can understand your concern you about your friend. She said.
That it was having seizures. Ive just never had this kind of pain before yeah. And i can understand that and you know so what i would like to do is weve pretty much gone over your history.
What id like to do is complete a physical exam. Do some testing all right and i want to ask to if theres any other concerns i need to address before we get to that way. Im.
Sam okay. That sounds good okay sounds great okay all right hi. Im deb you know im yours free standardized patient nice job im going to give you some feedback on your communication skills and in this encounter.
But before i do how did you feel it went um pretty good. I was i was nervous at first. I think and just trying to make sure that i was getting all your outpatient information.
So we could make sure we got the correct tests. And yeah. Yeah no yeah.
How did you feel when you when you walked in you feel pretty comfortable uh. I think i got more comfortable as we sat down. And i could see that yeah good okay um.
Well. I thought you did a nice job. You had an appropriate introduction introduced yourself first and last name shook hands.
I think you have a very warm demeanor and youre comfortable which makes me as a patient comfortable you did excellent. My chief complaint and asked for any other concerns and thats when i told you i was also concerned about my insurance. So that was another thing on the agenda.
So you did set in a mutual genda. Asked me if i agreed and so we had a clear roadmap going forward. So you did you hit all those real.
Well you your first question. Tell me about this pain or that was a nice open ended question so allowed me to then tell my story followed up with some or pointed questions just for clarification on and you had youre an active listener had good contact eye contact and could do a little bit. More reflective.
Listening just of little points. Where you could verify check for accuracys of maybe paraphrase as im going through through you did a nice summary in the middle thats good. But just a little bit more reflection on that to let me know as a picture that youre hearing.
Me you asked my perspective of what i thought was going on and then you got the story of mike. Fear. That ive got a brain tumor.
Oh no yeah so i thought. You had a nice flow. Logical sequence of questioning a little bit of signposting we just covered this and now were going to do that i heard that once and as these interviews get longer youre going to want a signpost between each section.
Ive taken your history now id like to go into a physical exam. Okay thing did a nice summary in the middle you move through quickly so you attended to the timeline. You did ask permission permission to ask some social questions.
Maybe you want to mention social questions may not be a flag for me. That this is this could be personal or uncomfortable maybe. Im going to ask a little more some personal questions here is that alright with you youre sawing.
So that question sounds fine to me until you start asking something that might sound personal. So you might use the word. Some more personal questions here naj non judgmental.
Didnt you know didnt bat an eye. When when i said i smoked half a pack you have nice vocal range. I contact a comfortable demeanor so that felt real good and then you did a summary at the end.
And asked did you ask do anything else okay so anything else before we do a physical exam. So it was very nice nice and my honor thank you so much uh huh nice meeting at youtube. .
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