Goals:

• Give comprehensive and appropriate information
• Assess your individual patient’s information needs
• Neither restrict or overload your patient

Chunks and Checks

• Give information to your patient in digestible chunks
  • Aids accurate recall
• Check for your patient’s understanding
  • Helps to achieve a shared understanding
• Use your patient’s response as a guide on how to proceed

Doctor: ‘Given the symptoms you’ve described and the fact that you wheeze more after exercise and at night, I am fairly confident what you are describing is asthma and that we should consider giving you some treatment for it’ (Pause) ‘Does that make sense so far?’

 Patient: ‘Yes I think so, but I’m not really sure I understand what asthma is. Does it run in families?’

Assess your patient’s starting point

• Ask for prior knowledge early on
  • Allows you to gauge what level to give information at
• Determine your patient’s wish for information
  • This wish may be dynamic over time

Doctor: ‘How much do you understand about diabetes already?’

Patient: ‘I think I know a fair bit, both of my parents had it’

Doctor: ‘It’d be helpful foor me to understand a little of what you already know so I can fill in any gaps for you’

Exercise: Asking your patient’s about how much they would like to know can be awkward if it isn’t stated matter-of-factly and confidently. Role play this and brainstorm ways in which your patient might react poorly and how you might handle these situations.

Doctor: ‘There’s a lot of information that I’d be happy to share with you about Parkinson’s disease and how we usually treat it. Some patients prefer to know a lot about these things while some prefer to keep it to a minimum. How much information would you like now?’

Patient: ’I’m not sure how much I’ll be able to absorb today. Maybe we can organize some treatment now and I can come back with my wife to get filled in on the information?’

Ask your patient what information would be helpful

• Patients often have questions such as: What has happened? Why did this happen? Why to me? Why now? What can we do to treat it? What if we don’t treat it?

Doctor: ‘Are there any other questions you’d like me to answer or any points I haven’t covered?’

Give your explanations at the appropriate time

• Avoid giving advice, information, or reassurance prematurely

Near the beginning of the consult…

Patient’s mother: ‘Sophie seems pretty sick with this cold. Can we get some antibiotics for her?’

Instead of…

Doctor: ‘I’m sure the answer isn’t antibiotics, if what she has is a cold then antibiotics won’t help’

 Try this…

Doctor: ‘That’s a good question. Let’s put that on hold for a second and come back to it after I’ve asked some more questions and done an exam to figure out whether this really is a cold, which normally doesn’t need antibiotics, or something more serious like a lung infection.’