Behavioral science Q

[LuckiestOne]

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A 45 year old woman with rhuematoid arthritis calls the physician on a Saturday mornin because she cannot turn the bathroom faucet due to pain and weakness in her hands and wrists she is tearful and says."My husband has already left for work and my hands are too weak to turn the water on,it hurts too much and now I can't even take a bath " Which of the following is most appropiate response ?

a.-"come to the office right away and I will give you a cortisone shot "
b.-" I know this must be difficult,perhaps a plumber may be able to help you"
c.-"I sympathize with you,unfortunately,it looks like your only option is to wait until your husnabd comes home "
d.-"many people with rheumatoid arthritis have difficulty turning faucets,perhaps you would be interested in joining a support group"
e.-"people with rheumatoid arthritis often feel that their independence has been los because of their pain,perhaps a tool with a long handle would help"

I feel really uncomfortable with behavioral questions, if you could give your answer and the rule that you used to come to that answer, it would be greatly appreciated!

 

[whatdidigetinto]

I'd go with D. Her problem is coming to terms with her disability. She needs emotional support which can be provided through a support group. Also a doctor is only supposed to give medical advice. Advising which tool to use when trying to open a faucet is not medical as far as i know. However, proposing that the patient should visit a support group is in fact medical advice.

 

[Belleza156]

E. Shows empathy and understanding. Best answer out of the bunch. Support group is often the answer in behavioral questions, but in specific scenarios that warrant that advice. This isn't one of them. Telling them to go to a support group in this case is equivalent to referring the patient.

 

[whatdidigetinto]

So a doctor can give out plumbing advice then?

 

[Myxedema]

So a doctor can give out plumbing advice then?

Haha, no, but the rule of thumb in these type of questions is that you take responsibility of your patient (i.e. you don't pass the bucket). Before referring her to a support group, you must take some kind of action, even if it's just giving a small advice. It's not that D is wrong, but E is better.

TL;DR: Always take care of your patient personally first.

 

[whatdidigetinto]

Til

 

[LuckiestOne]

The unofficial answer given was A... any thoughts? :/

 

[Boardz]

The unofficial answer given was A... any thoughts? :/

E. is the official answer.

 

[Morsetlis]

A could follow D or E, but D or E are more appropriate first answers.

I'm not sure E is a terrific first answer... but it fits with not pawning your patients off to other healthcare providers.

 

[Belleza156]

The unofficial answer given was A... any thoughts? :/

Umm how about WRONG!!! If the lady cant even use her hands to flush a toilet, how would you expect her to open door knobs, turn on a car, etc. That is so obviously not the answer.

 

[LuckiestOne]

Umm how about WRONG!!! If the lady cant even use her hands to flush a toilet, how would you expect her to open door knobs, turn on a car, etc. That is so obviously not the answer.

No need to be hostile, I picked E as well. I am just providing the information that came with the offline NBME.

 

[Belleza156]

No need to be hostile, I picked E as well. I am just providing the information that came with the offline NBME.

I wasn't being hostile, sorry if it came out that way.....it's just animated text anyhow 🙂