Make the past medical history more meaningful
I listen to around 10 presentations each week. Students, interns and residents present patient histories and I often have to interrupt. My expectations are, apparently, different from how they were taught. Here are some of my pet peeves – please feel free to expand the list:
Diabetes – please tell me what type and how long the patient has had diabetes. A 1-year history of diabetes has very different implications than a 15-year history
CHF – systolic, diastolic, valve related – what is the ejection fraction – what is their current function
COPD – on home oxygen, emphysema or bronchitis
CKD – please tell me the stage (it matters) and the likely etiology (if known)
Cirrhosis – why, MELD score
When I hear any of those diagnoses, I need clarification. Our thinking changes and become more focused when we specify the PMH more specifically.
I probably fall into this trap myself when quickly telling a patient story to a colleague. Do you?
Source: DB's Medical Rants - Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs