There is a skill in rapidly figuring out what personality traits/disorder someone potentially has, what fear they have, or what their primary objective is for the visit.
Some really want a diagnosis. If unknown, all documentation must still reflect caution and ambiguity for medicolegal protection, but verbally some of these patients benefit from giving a firm answer with authority even if still quasi-ambiguous. Throwing out one or two unknown medical terms helps.
“It’s likely an inflamed and pinched nerve from the brachial plexus.”
“You have viral pharyngitis. A lot of Adenovirus has been going around. I think it’s very likely that.”
“Your pain is likely intestinal spasm and dysmotility from increased stool burden also leading to gastritis.”
You don’t straight lie and patients should clearly understand return precautions. Unfortunately the only way for both yourself and people with certain personality disorders to leave an encounter satisfied is to convey expertise that a physician can provide when the testing is ambiguous. Uncertainty even if absolutely right leads to distrust on the part of some patients with everyone ending up unhappy.
You are trying to do the right thing every time. Unfortunately, the right thing has to fluctuate for reach patient depending multiple factors including but not limited to their age, intellect, and actual symptoms or disease process.
