1.

WANTS PAIN MEDS

a. I UNDERSTAND YOU’RE IN PAIN, AND I WANT TO HELP YOU
i. AT THIS POINT, to give you the RIGHT PAIN MEDICATION, I need to know
what’s causing it. I DON’T WANT TO GIVE YOU THE WRONG MEDICATION,
WHICH COULD BE HARMFUL. SO PLEASE LET ME ASK YOU SOME QUESTIONS
AND DO A PHYSICAL EXAM. After that I will give you pain medication. Is that
okay with you?

CLOSURE EVERY CASE:

1. Based on your SYMPTOMS, and Physical Exam, I THINK IT’S POSSIBLE YOU HAVE ___________
Or ________________ THAT CAN BE CAUSING YOUR “CC”
 A blood clot
 Colon cancer
 BPH
 GOUT OR AN INFECTIONG…THAT CAN BE CAUSING YOUR “KNEE PAIN”
2. FIRST, I WILL PERFORM A RECTAL EXAM (BOTH); [GENITAL EXAM, BREAST/PELVIC)
a. TO ASSESS (YOUR PROSTATE, CERVIX)
3. THEN I WOULD LIKE TO ORDER Some Blood tests
4. POSSIBLY GET a urine sample – to look for signs of infection
a. [OBTAIN FLUID FROM YOUR KNEE – GOUT]
5. THEN WE MAY ALSO ORDER SOME IMAGING STUDIES OF YOUR ______[Abdomen/Chest/etc]
DO an EKG
a. [To determine if there’s a (stone in your kidneys, an anatomic abnormality, or
something else)
b. CXR/IMAGE OF YOUR CHEST…
6. TO SEE IF WE CAN CONFIRM THE DIAGNOSIS
a. TO SEE IF WE CAN NARROW DOWN AND MAKE A FINAL DIAGNOSIS (IF UNSURE)

(then we will be able to treat your condition and help alleviate your symptoms)

7. IN THE MEANTIME, I RECOMMEND YOU STOP (USING) “SOME LIFESTYLE CHANGE”

a. cocaine, smoking, drinking alcohol
b. SINCE THESE CAN LEAD TO A VARIETY OF MEDIAL PROBLEMS (LIKE HEART ATTACKS)

COUNSELLING: [smoking-alcohol-safe sex-drugs-Abuse-Medication COMPLIANCE-DIET-Exercise]

Diagnosis+Work up..…IN THE MEANTIME,
SMOKING
a. Since cigarette smoking is dangerous for your health, I advise you to quit smoking; we
have many ways to help you if you are interested.
b. Since cigarette smoking is associated with a variety of diseases, I advise you to quit
smoking; we have many ways to help you if you’re interested.
ALCOHOL
c. I also recommend you stop drinking, as alcohol and smoking are associated with (….
Laryngeal cancer)
d. We have many ways to help you if you are interested
DRUGS:
e.
SAFE SEX/CONDOM occasion:
 f. I know condoms may be difficult to use regularly, but they are important in helping
control the spread of STDs.
g. I also recommend you use a Condom every time you have intercourse to prevent STDs,
including HIV, and to avoid pregnancy.

HIGH BLOOD PRESSURE:

h. Your BP was 135/88, which is close to our target of 130/80. However, it would be even
better if we could get it down to around 120/80.
i. That should be doable with lifestyle changes like decreasing your salt & fat intake &
increasing the amount of exercise you’re doing
j. I am ordering some BLOOD TESTS to make sure your problem is not due to any other
medication condition
k. I would like to perform a (genital exam as well as a rectal exam to assess your prostate)

MEDICINE COMPLIANCE:
l. In the meantime, I want to stress the importance of being compliant with taking your
medications so that you can prevent future complications

POOR DIET (Diabetes, junk food, elderly no veggies)

m. I also would like to recommend you working on having a BALANCED DIET and eating
PROPERLY with portion control, with more vegetables, and decreased sodium intake)

DON’T EXERCISE often – stagnant/sits on couch all day/obese

n. I also would recommend you participating in REGULAR Physical Activity for at least
30mins a day, being more active, going for walks.

WE HAVE MANY WAYS TO HELP YOU IF YOU ARE INTERESTED. HOW DOES THAT SOUND TO
YOU?

8. DO YOU HAVE ANY QUESTIONS FOR ME?

CHALLENGING QUESTIONS:
2. Can we do another time? / MY VACATION WITH FAMILY
a. I UNDERSTAND WHERE YOU’RE COMING FROM,
i. AT THIS POINT, AN ACCURATE & EARLY DIAGNOSIS IS IMPORTANT, AND THESE
TESTS WILL NOT TAKE MUCH OF YOUR TIME
b. It’s IMPORTANT WE PERFORM SOME TESTS to identify the SOURCE OF YOUR
PROBLEM, and TEST RESULT SHOULD BE BACK IN A FEW DAYS, AND GIVE US A GOOD
IDEA WHAT IS WRONG WITH YOU.

3. AM I GOING TO DIE?/ my dad has cancer, will I get it too?/I’M CONCERNED….

a. I UNDERSTAND YOU’RE CONCERNED ABOUT YOUR HEALTH, AND WORRIED.
i. AT THIS POINT, I CANNOT SAY FOR SURE HOW SERIOUS condition may be.
However, based on the TEST RESULTS, I’ll do my best to take care of you and
provide you the best treatment available. How does that sound?
b. I UNDERSTAND YOU’RE CONCERNED ABOUT YOUR HEALTH. WHATEVER THE
DIAGNOSIS, I WILL DO MY BEST TO HELP YOU

c. I WILL DO MY BEST TO TAKE CARE OF YOU

 d. I UNDERSTAND YOU’RE CONCERNED ABOUT YOUR HEALTH, AND THAT YOU’RE
WORRIED. I WANT TO ASSURE YOU this is a TEAM EFFORT and you will see me again;
an I AM ASSESSABLE to you at any time. Is that okay with you?

AGAIN
9. Based on your symptoms, and physical exam, I THINK IT’S POSSIBLE YOU HAVE ___________
Or ________________
10. FIRST, I WILL PERFORM A RECTAL EXAM (BOTH); [GENITAL EXAM, BREAST/PELVIC)
a. TO ASSESS (YOUR PROSTATE, CERVIX)
11. THEN I WOULD LIKE TO ORDER Some Blood tests
12. POSSIBLY GET a urine sample
13. THEN WE MAY ALSO ORDER SOME IMAGING STUDIES OF YOUR ______[Abdomen/Chest etc]
a. [To determine if there’s a (stone in your kidneys, an anatomic abnormality, or
something else)
14. TO SEE IF WE CAN CONFIRM THE DIAGNOSIS
a. TO SEE IF WE CAN NARROW DOWN AND MAKE A FINAL DIAGNOSIS (IF UNSURE)
15. IN THE MEANTIME,

16. Do you have any questions for me?