HONESTY is priority

UNCERTAIN CASE
HONESTY is priority
• I’ll be honest we are not 100% sure at present but it potentially could be
something serious
• It may end up being absolutely nothing – we just cant say at present
• It would be wrong of me to give you incomplete information at this stage
ACKNOWLEDGE
I can see how waiting and not knowing is a huge challenge at present
Practically, it may be part of the assessment
How do you deal with uncertainty as a doctor
There deliberately may be no answers/diagnosis
Remember others will feel the same uncertainty as you!

UNINTERESTED PATIENT
ACKNOWLEDGE they don’t want to be there
• I can see that you don’t seem to want to discuss your diabetes today
• I can appreciate that there are many other things that you would rather be
doing than discussing your diabetes
• Is there any way that you would like us to address your diabetes?
ICE
• Why do you think your diabetes is uncontrolled?
• You don’t seem to be too concerned by what we’ve told you about your
diabetes…Is there anything that worries you about your diabetes?
• I know you didn’t really want to be here, but now that you are here, is there
anything that you think I can do?
TARGETED second half to consultation
• I know you mentioned you were worried about your kidneys – why don’t we see
what we can do to save those
• Let’s try and look at your weight/exercise/medication to help save your kidneys
• If we don’t tackle your diabetes, we may well end up losing your kidneys
• Mr. X are you aware of any risks that health can lead to?
• Are you aware how your diabetes can be improved through reducing weight
• Your BMI is a measure of height against weight. Unfortunately yours does come
in the obese category and this does come with some risks
• Practical strategies as with diet and exercise slides