Difficult Questions

Question 1

Anxious patient

Answer 1

• ask about anxiousness

- validate with anyone in your situation would be anxious

Question 2

Angry patient

Answer 2

• inquire about anger

- validate feelings

Question 3

Crying patient

Answer 3

• offer tissue

- allow them to cry

Question 4

Pain

Answer 4

• I will be quick and gentle

- offer to make patient more comfortable

Question 5

Can’t pay for tests

Answer 5

-refer to social worker

Question 6

Refuses to answer questions

Answer 6

• explain why it is important

- document refusal in note

Question 7

Unsure of medication names

Answer 7

• ask for list

- bring or fax to clinic

Question 8

Confused patient

Answer 8

-ask if there is anyone who knows about the problem

Question 9

Phone encounter

Answer 9

• press yellow button

- no PE so leave it blank on exam

Question 10

Needs assistance making decisions

Answer 10

-help understand disease or problem management

Question 11

Should I tell sexual partner about STI

Answer 11

Yes-he or she may be the source of your infection and evaluating both of you is important

Question 12

Why are you asking me these questions

Answer 12

concerned about your safety

Question 13

HIV reporting

Answer 13

talk to your wife, must be reported

Question 14

wrong patient

Answer 14

take vitals again

Question 15

normal aging

Answer 15

not necessarily-some tests will help us determine if it is normal or not

Question 16

prefer taking more holistic remedies

Answer 16

check into potential treatment

Question 17

afraid of surgery

Answer 17

what specifically are you afraid of

Question 18

come back for testing

Answer 18

serious problem

take care of it before you leave

Question 19

could not understand question

Answer 19

repeat it slowly

ask if specific word failed

Question 20

workup

Answer 20

tests to get final diagnosis

Question 21

ask if too late for recovery

Answer 21

never too late to seek help

do our best to help you

Question 22

am I going to die

Answer 22

need to do some tests to confirm the diagnosis and rule out other problems

Question 23

asking for you to refill script

Answer 23

cannot give refill without first reviewing history

Question 24

asking if insurance will cover cost

Answer 24

not sure but refer to social worker

Question 25

can I go back to work

Answer 25

I can write a letter for your employment explaining your situation

Question 26

tumor becoming malignant

Answer 26

unsure until we get more reports on it

Question 27

gained weight since smoking

Answer 27

increased risk of cancer and heart problems

other ways to decrease weight

Question 28

afraid of losing job if not getting better

Answer 28

do our best for recovery and with your permission can convey whats going on to employer

Question 29

life of misery

Answer 29

what is bothering you? have you thought about ending your life

Question 30

child home alone right now

Answer 30

social workers to arrange for child care

Question 31

malingering back pain

Answer 31

not enough on physical exam for being off work

movement is best option along with stretches and pain killers

Question 32

bleeding and needs transfusion

Answer 32

serious reaction or religious belief or someone died

Question 33

no answering

Answer 33

please have a seat so that I can help you

Question 34

keeps repeating questions

Answer 34

inquire as to why

Question 35

asks question while you are washing your hands

Answer 35

tell him that you want to wait and give him your full attention

Question 36

needs to take bathroom break

Answer 36

allow and ask if they need any assistance

Question 37

wants to be examined by another doctor

Answer 37

find out why

reassure that you are qualified and can address concerns

Question 38

auditory hallucinations asks if crazy

Answer 38

a lot of things can cause this some are psychological

no diagnosis as crazy in medicine

Question 39

asks if previous doctor made mistake

Answer 39

may have had different treatment plan but made best clinical decision

Question 40

asks how to deal with gay son

Answer 40

ask if she has any guilt or confused feelings and encourage counseling

Question 41

hormone replacement treatment and breast cancer

Answer 41

risk of developing breast cancer after long time

goal is low and for as short as possible

Question 42

patient wants antibiotics

Answer 42

viral

Question 43

family history of breast cancer

Answer 43

family history plays into it but there are many other factors

Question 44

removed polyp

Answer 44

depends on what they found and will need a colonoscopy

Question 45

pregnant even though tubes are tied

Answer 45

no 100% effective contraception

Question 46

vaginal bleeding in first trimester asking about miscarriage

Answer 46

bleeding increases risk but most women with bleeding carry to term

Question 47

stop smoking with COPD

Answer 47

gradual improvement

Question 48

possible appendicitis asks for water

Answer 48

rule out the need for surgery