In this episode I talk through how to getting the most out of the limited time slot you get with your family doctor.
PART I - PREPARING THE HISTORY
Preparation is key when it comes to seeing your doctor. Take a moment in the waiting room to think about your problem. You might want to think about how it started, is it getting better or worse, are there any triggers, is there anything associated with it. Take a think about any solutions that you may have tried. All too often, nothing is done by patients, but sometimes trying a solution such as an anti-inflammatory medication for knee pain, can help the doctor to work out the diagnosis. If you’re forgetful it might be worthwhile bringing in a list of symptoms for your problem. It may be that you have more than one problem, if this is the case, inform your doctor at the start of the consult to work out which is the priority problem and which can be reviewed at a later time if time does not permit.
PART II - PREPARING FOR EXAMINATION
Now that you have succinctly and coherently put across your problem, your doctor may then interact with you through a number of ways. They may ask you questions whilst you are talking to help keep the conversation on track and to obtain any important salient details about your problem, aiding them with their thought process. Your doctor may then wish to perform an examination. Sometimes this is not always necessary, however if you suspect an examination may be required it’s important to consider this during your preparation. For example, if you have knee pain, your doctor may need to examine your knee, so think about how easy it will be to access your knee with your attire. It might be that you are coming in for an intimate examination, and for this you may need to prepare appropriately with washing or attire.
Once your doctor has performed an examination they may request some further tests, this could take the form of blood tests or radiology to name a few. In these situations, results can take around 2-3 days and you may be required to return at a later date. In some situations like this, the doctor may be unable to give you a diagnosis straight away and so your patience is appreciated. You could use the opportunity of having to return as a time to reflect on your problem and think about whether you have missed anything or want to clarify something with the doctor. Following on from this, be sure to check your understanding at the end of every consultation. Sometimes doctors use medical language or jargon, that is hard to understand. As a habit, I always go through reports or results with picture aids to ensure patient understanding. Generally, if you ask your doctor for clarification on something, they will be happy to help.
Finally, know that the doctor has your back. Remember the doctor has taken a hippocratic oath to do you no harm and to provide you with the best form of treatment that is suitable for your condition. You should generally seek advice from your primary medical practitioner as they know your history well. However, if you feel uncertain about something the doctor has said or you want a second opinion, it is ok to do this. Most of the time, the management will be the same as your usual doctor, which helps to reinforce and reassure the patient-doctor relationship. However, on very rare occasions, I, as a second opinion doctor have found there to be outliers, where I have changed the management to save lives. This goes back to preparation, very often when you see the second opinion doctor, you may have a better understanding of your problem and so when you portray your symptoms for a second time, it may lead the doctor in a different direction.
Join me in part 3 of the series ‘A Day in the Life of a General Practitioner’. In this episode I give you a VIP tour of the other clinic I work at in Southport. Showing you the facilities including my personal office and explaining the tools I use as I go.
Join me as I take you behind the scenes at our medical centre in the Gold Coast (dubbed a Coronavirus Hotspot by the news) to see how we clean the practice, triage patients and prepare for our day in the midst of a Coronavirus outbreak.
Outside of the door we have clear signs advising patients who think they may have Coronavirus or have symptoms of the virus to stop and call us for advice. We have posters and information of the local testing centres clearly displayed as we are not geared up to have in-house testing.
We start the day by disinfecting common areas with medicinal grade detergent, including the reception desk, doctors office, appliances and any waiting room surfaces. We ensure that patients are seated well away from one another to avoid any spread of infection in a closed space.
Patients call in for appointments and will be triaged by reception or a nurse to ensure that they are not putting other sick patients at risk. It is easy to forget that medical centres need to remain open to cater for those who may be suffering from chronic health conditions such as diabetes, lung problems or cancer. It is of utmost importance to ensure that such patients are not subjected to any potential Coronavirus sufferers in the waiting room. All patients are required to use hand sanitiser and are offered masks if warranted.
Patients who are deemed unable to attend the practice are offered telehealth consultations in lieu of a face-to-face consult.
For added safety, front line staff such as receptionists and doctors use N95 masks and other protective gear during their working day to minimise any potential exposure. These are then disposed of and areas are disinfected again.
So far, to date we have not had any Coronavirus patients or suspected patients. This could only be possible with a team effort from the staff and from you as patients. We request that you call in to book an appointment so we can assess the nature of your visit.
As a medical doctor, I urge you to help flatten the curve, be sure to follow strict social distancing of 1.5m, practice regular thorough hand washing, self-isolate and avoid large crowds. Together, as a world, we can combat Coronavirus.
Join me next time where I take you through some patient experiences of Coronavirus.
I hope you’ve found this video useful and always, if you have any questions or comments, please don’t hesitate to drop me a line below.
Working as a general practitioner in Chinatown and Surfers Paradise, a major tourism hub, my first instinct when the news broke of the virus was to ensure that I was keeping myself and patients protected. Hunting down an elusive P2/N95 mask was a struggle but I eventually managed to source some for myself and staff.
In clinic, my staff have done a great job at screening patients prior to booking appointments and thanks to the Australian media, patients travelling from China are very well versed in the precautions that they should take. This is unlike what has occurred in London, where a lady with Coronavirus presented herself to the emergency department without letting the teams know in advance.
Here in Australia, I have seen some patients from Hong Kong and whilst there was some anxiety around their recent travel, they were most respectful and reported that they had no symptoms but instead had presented for a minor ailment. Many of the local Chinese community living in the area have themselves been concerned about going into Chinatown so not to propagate the virus and have even been wearing masks despite not having symptoms. There has very much been a strong community movement in containing the virus.
One common consultation that I do have unfortunately, is that of anxiety surrounding the Coronavirus. All too often I am presented with patients who are suffering severe anxiety, taking the form of work avoidance, staying at home and even avoiding using the lift in their high rise apartments so instead using the stairs. This is heartbreaking for a general practitioner and such patients are offered psychological support to address the root of their anxieties. If this sounds familiar to you, please know that there is help out there and I would encourage you to speak with your doctor about this.
Other patients have presented using multiple face masks in the hope of getting extra protection. There has been no recommendation for this, as long as your mask is fitted well, one should suffice. These patients are at risk of getting quite severe mask fatigue as the masks can be quite thick and difficult to breath leading to dehydration and headaches.
In other consultations, some patients are turning up requesting to be tested for the virus as they may have passed someone close by coughing or sneezing. Such patients have usually attended the emergency department and have been referred back to their GP as they do not fulfil the criteria for testing.
It is important to know that not all general practitioners have the ability to test for the virus, so if you are suspicious you may have it, it is imperative to call in advance to check and also so that staff can be ready to isolate you from other patients. This is also true if you are presenting to the emergency department.
As a practice, we ensure that at the end of the day we wipe down all surfaces with bleach as we know this destroys the virus and our equipment is cleansed after use with each patient.
On a lighter note, one great benefit of wearing the mask is protection against the common cold. Very often I get patients who present with a cough or runny nose and will cough on demand to ‘prove’ a point. As general practitioners we are well trained in detecting such ailments so please refrain from coughing on us as it could mean we pass those bugs to others or take them home.
On the other side of the spectrum, I have some patients who are completely oblivious to the situation. Some of which ask me ‘Doc, why are you wearing that mask? Are you sick?” As a healthcare professional I am in a privileged position to advise others about current health precautions.
The best way to protect yourself is to practice regular hand hygiene, making sure to wash your hands under running water with soap for at least 15 seconds. Of course if you are unwell or you suspect that you may have the Coronavirus, please self isolate and contact you local emergency department or doctors office prior to visiting.