CS Query - Phone Consult

[NuMD97]

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I have seen that the NBME covers the contingency of a patient calling the doctor's office, and the doctor needing to field the patient's concern as a possible exam station on the CS exam. Has anyone actually seen this as one of the cases on the CS exam? Just curious.

 

[Kholdstare]

I had a phone case. It says on the door something along the lines of "this patient is sick with blah blah blah and is calling you for advice - cover the pertinent areas of the history and come up with a differential". So you walk in and hit a button on the speaker phone and it calls the person. You can talk and ask them whatever you want. Then once you hang up you can not call them back again. You write it all up like a regular note, except under physical exam you put something like "patient not present".
It was really easy - probably one of the easiest stations of the day. Good luck! 😀

 

[daru1]

I agree, by far the easiest station, because the time usually spent on p.e. and "the magic question" is spent asking questions. Without going into specifics, I asked the questions in the order of your note and had it written by the time I went to put it on the computer.

 

[NuMD97]

Thanks, folks, I very much appreciate your input. One question though: They don't want any follow up or what your recommendations might be to the patient (those are usually entailed in real-life patient phone queries) just the history and a DDx?

Again, I appreciate your replies.

Nu

 

[Kholdstare]

Thanks, folks, I very much appreciate your input. One question though: They don't want any follow up or what your recommendations might be to the patient (those are usually entailed in real-life patient phone queries) just the history and a DDx?

Again, I appreciate your replies.

Nu

Don't worry the directions will tell you exactly what to do..... I would plan on giving followup as well as recommendations.

 

[deucerp]

my phone case was probably the hardest of the day...it was so "different" that I'm pretty sure it was one of the two they were testing. But I agree, most people I've talked to said the phone consult was pretty easy

 

[NuMD97]

Don't worry the directions will tell you exactly what to do..... I would plan on giving followup as well as recommendations.

That's what I thought as well. Thanks to all who replied.

Nu

 

[RugbyJC]

In real life, I would rather see a patient in person than handle their concern over the phone, so I asked if the patient was availible later in the day to schedule an appointment. When she said she was I briefly discussed the issue just to make sure it did not require immediate medical attention.

Was this wrong?

 

[NuMD97]

In real life, I would rather see a patient in person than handle their concern over the phone, so I asked if the patient was availible later in the day to schedule an appointment. When she said she was I briefly discussed the issue just to make sure it did not require immediate medical attention.

Was this wrong?

I believe that that is the key to this type of question: To discern if the patient needs immediate attention. One friend, an FM doctor, used to post a protocol by the phones so the staff who were non-medical could field calls that were urgent in nature and that required an immediate trip to the ED.

If you don't have the time to schedule the patient (for test purposes), and it is a non-threatening situation, based on your detailed inquiry, I would hazard a guess that what they want you to do is to reassure the patient that it isn't life-threatening and schedule an office visit as soon as it can be arranged.