Etiquette On History Taking And Physical Examination

PROF DR ZABIDI AZHAR HUSSINCONSULTANT PAEDIATRICIAN

2nd August 2006

Etiquette On History Taking And Physical Examination

WHY BOTHER?

Etiquette On History Taking And Physical Examination

HISTORY TAKING MAKES OR BREAK

Etiquette On History Taking And Physical Examination

WHO IN THEIR RIGHT FRAME OF MIND WOULD:See a foreigner and talk about their weakness

(illness)and confidential secrets

Travel at great expenses of time and money to meet a stranger

Etiquette On History Taking And Physical

ExaminationWHO IN THEIR RIGHT FRAME OF MIND

WOULD:Expose their most secret parts to an

unknown stranger?Give their body fluids ( blood etc ) to

be drained for some unusual tests done by unknown strangers?

Consent to most humiliating positions where medical tests are done?

Etiquette On History Taking And Physical Examination

DOCTORS HAVE THE PRIVILEGES OF MAKING PEOPLE DO WHAT THEY

WOULD NOT NORMALLY DO

Etiquette On History Taking And Physical Examination

THE POWER LIES IN THEIR ABILITY TO COMMUNICATE

AND SHOW THEIR EMPHATY

Etiquette On History Taking And Physical Examination

HISTORY TAKING AND PHYSICAL EXAMINATION ARE THE ESSENTIAL KEY TO THIS

POWER

Etiquette On History Taking And Physical Examination

HOW TO WIN PATIENTS CONFIDENCE IN YOU?

Etiquette On History Taking And Physical Examination

Etiquette On History Taking And Physical Examination

Appearance and Mannerism- unhurried, neat, clean white coat,

body odour, bad breath, shoes, preparedness, interest, interruptions, courtesy to relatives, compassion ( someone may be in

pain or have just been told a bad news)

Etiquette On History Taking And Physical Examination

Verbal and Body Language-appropriate language( dialect, choice of language) and salutation ( try to gauge where patients come

from and the language he speaks ), ascertain how he wishes to be addressed as ( Pak Cik, Abang etc)

- Guide him to tell his story and do not interrogate (finger pointing, pen pointing, loud voice, frequent

prompting not interrupting- Maintain your interest ( force your interest if

necessary)

WINNINGPATIENTS CONFIDENCE

Etiquette On History Taking And Physical Examination

Verbal and Body Language- Careless and inappropriate body language can

convey misleading messages. Therefore beware!- Frequent nods help

- Careful not to convey elements of judgmentin your body language

Etiquette On History Taking And Physical Examination

Verbal and Body Language- Donot be judgmental of patients ( outer appearance may be deceiving, our values are the same, but our

covers may be different, - Do not take sides or attempt to educate patients

during history taking- Do not force patients to accept your technical jargons

and try to fit patients complains into your neat categories

Etiquette On History Taking And Physical Examination

Always seek permission to examineAlways examine together with chaperons

Only one person should touch at any one timeThose watching must not make inappropriate body

signals or points to patients body partsNever laugh, giggle or smile during physical

examination , as patients may take this as a form of insult

Always preserve patients dignity we all have one! Cover , cover, cover

Etiquette On History Taking And Physical Examination

Never hurt a patient. Apologize if you think you have accidentally hurt them

Be careful of inappropriate touch of the opposite sexBeware of local customs ( e.g. the use of right hand is

always preferable in Malay community, always ask permission to touch the head

Never remove patients ornaments without prior consent

Always thank them when you have finished

Etiquette On History Taking And Physical Examination

ENJOY YOUR HISTORY TAKING. TAKING A GOOD HISTORY IS LIKE READING A GOOD TEXTBOOK

CHRONOLOGY IN HISTORY

HPC PC TODAY

Symptoms/signs

progress

Presentation moves events forwards

Etiquette On History Taking And Physical Examination

GOOD LUCK!

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