Today SL, one of my team 2 colleagues, was scheduled to give us a tutorial on the principles and effects of different treatment modalities but due to new patient clinic this was cancelled. Instead I joined a colleague during his new patient clinic as an observer. During the case history I noticed how seldom I actually can join new case histories from my fellow students due to time constrain. However this would be very helpful at this stage. Me and the observing tutor followed the case history process and filled out the '4th Year New Patient Clinic Feedback Sheet'. I really appreciated to take part in this process as our CCAs will mimic this situation. Afterwards we discussed altogether our strengths and weaknesses.
The feedback I gave to my colleague towards the overall case history that the timing needs to be worked on. I agree that in this patient it was better to choose open questions to get full detailed answers but this lead to a delay from early on during the process. Lifestyle issues were considered and noted but not detailed enough. For instance did the patient enjoys doing exercise classes, this was noted but not further explored. The patient gave hints but I could feel was not confident enough to explore it more in detail as he was not sure if this is relevant. For the next point on the assessment sheet I noted that a clear and structured assessment routine is essential. I nearly wanted to step in when my colleague forgot to do an active spinal movement assessment and also did the general observation of the standing/sitting posture got lost. Considering clinical reasoning and choosing the most valid tests I mentioned during our feedback discussion that a neurologic examination would be an essential step when a patient presents with pins and needles but also loss of sensation in the lower extremity. I can understand that this formative assessment is very stressful but all those mentioned points are necessary to make the clinical working diagnosis. At the end of the appointment the patient asked if he is 'treatable' and if we could help him. By that point it was not made clear to him what he was diagnosed with and if osteopathic care would benefit him with his symptoms. I think it is essential to explain all our patients in a clear way what we think is causing the pain and how we consider to treat them, thats the right of a patient.
The feedback I gave to my colleague towards the overall case history that the timing needs to be worked on. I agree that in this patient it was better to choose open questions to get full detailed answers but this lead to a delay from early on during the process. Lifestyle issues were considered and noted but not detailed enough. For instance did the patient enjoys doing exercise classes, this was noted but not further explored. The patient gave hints but I could feel was not confident enough to explore it more in detail as he was not sure if this is relevant. For the next point on the assessment sheet I noted that a clear and structured assessment routine is essential. I nearly wanted to step in when my colleague forgot to do an active spinal movement assessment and also did the general observation of the standing/sitting posture got lost. Considering clinical reasoning and choosing the most valid tests I mentioned during our feedback discussion that a neurologic examination would be an essential step when a patient presents with pins and needles but also loss of sensation in the lower extremity. I can understand that this formative assessment is very stressful but all those mentioned points are necessary to make the clinical working diagnosis. At the end of the appointment the patient asked if he is 'treatable' and if we could help him. By that point it was not made clear to him what he was diagnosed with and if osteopathic care would benefit him with his symptoms. I think it is essential to explain all our patients in a clear way what we think is causing the pain and how we consider to treat them, thats the right of a patient.
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