Don’t give answer too early
If you say ‘no’ – could get angry very early
If you say ‘yes’ – will be difficult when you change to ‘no’ later
Regularly ACKNOWLEDGE the demand
• I know you really want the scan – I promise I’ll come on to that shortly
• I know you are really keen on the scan – I assure you I will get to it soon, just a
few more questions
Get to the ROOT of the demand
• Could I ask why you would like another CT scan?
• Has anything in particular changed since the last scan?
• Did someone go through the results of the last scan with you?
• Is there anything in particular that you hoped the scan would show?
• Has someone go through the pros and cons of ___
• Are you aware of the risk associated with this?
HISTORY
• I appreciate that you want the scan – unfortunately for me to make any
decision or sign a scan form I need to ask a few medical questions first…I hope
that is ok?
• Sometimes there are other scans that can be more beneficial in your case, let
me ask you a few questions to figure out which is the best investigation for you.
Potentially even better than X-ray
• There may be better things than a scan for your symptoms – I just need to know
a little more before we can see what would help you best
ICE
• Was there anything in particular that worries you about your headache?
ACKNOWLEDGE concern
• Now it makes complete sense, I can see why you want another scan – headaches
are not nice to put up with, and ____ is something people are worried about
• I can see where you’re coming from with this request
Be honest and REFUSE
• I’m very sorry but I really don’t think another scan is going to benefit you in
any way at present, there are a lot of side effects associated with ____ scan,
radiation for an example
• Our job is to weigh up pros against cons and I don’t want to do anything that
could potentially harm you
• You mentioned that you worried about brain tumour, I’m really pleased to say
from talking to you and examining you, nothing worries me about brain tumour
here. I can explain this in a little bit more detailed.
• Maybe some other steps we can do here to move the situation forward is to
look at a few things you mentioned in your story to deal with this headache,
what do you think?
Offer ALTERNATIVES
• I really don’t think it is something that can benefit you, but look I know you are
very keen – how about I discuss this with the radiologist for their opinion?