Explain to your patients any questions or physical exam maneuvers that might not appear to follow directly from their issue.

Exercise: Think of standard questions that we as health care professionals might ask about the following chief complaints that may not, on the surface, appear to be relevant to these chief complaints.

1. Chest pain
2. Abdominal pain
3. Shortness of breath

Examples

1. Groin exam in a patient with sore throat: looking for glandular fever
2. Checking for perineal sensation in sciatica for central prolapsed discs

Shortness of Breath – thinking about congestive heart failure

              ‘How many pillows do you sleep with?’

Exercise: what might your patient be thinking when you as this question?

Compare this to…

‘Do you get breathless when you lie flat at night? ‘Do you have to prop yourself up with several pillows?’

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.