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thoughts. The second open question can be set about
the biggest problem of the
patient which must be pictured in better way. And for this purpose the doctor has
to set special questions – what disturbs you more, or what made you come to me?
It is possible to ask about a pain when the patient complains of a pain or about a
diet when he complains of loss or gain of weight. These questions help a doctor to
collect more and correct information and at the same time to show the patient his
interest on the problem the patient has.
Practically all patients have their own opinion about their problems. In many
cases those opinions erroneous – didn’t wear warm clothes and had a flu, was
poisoned because of tea and begun acute diarrhea. But in each case it is necessary
to listen to opinion of the patient attentively and to disassemble with the patient.
By ignoring opinion of the patient the doctor loses his trust. It is possible to tell
«Yes you may have caught it because of cold, but most likely you have caught it
from the colleagues or members of your family. Further,
do not ignore fresh air
and a hot shower which will facilitate a disease currently».
Almost all patients try to treat themselves at home[14,15], and these
medicines should be cleared out. It would help to prevent poisoning by medicine.
Chronic
diseases, allergic reaction to a medicine and the epidemic anamnesis are
important at diagnostics and prescription of medicines.
It is possible to add
questions in other cases – travel and sexual contacts at young men, a sleeping and
appetite at the child. The patient actively involved in diagnostics and treatment
process. By it a part of responsibility for successful treatment can assigned on the
shoulders of the patient.
Some kinds of supervision have been applied to consultation discussion for
students –
direct supervision, a consultation audio record,
consultation video
recording. All these kinds of consultation observations have the advantages and
down sides, but video supervision can be the most advanced variant.
At video
recording it is possible to estimate verbal and nonverbal skills assumptions of
patients the doctor gains the confidence of the them[19]. Many mothers think that
no one may understand their
children better themselves, even doctors. If mum
confirms that without antibiotics he cannot recover from a flu in any way that it is
necessary to choose one from two harms – the patient
leaves without antibiotics
and finds other doctor or appoints antibiotics once a day for three days.
For an estimation of skills of consultation it was used a card of consultation
and a scale of an estimation of consultation.
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