Before I became a PA, I used my Master’s degree in Psychology to work with the severely mentally ill. During this time, I learned that everyone has a story to tell.
While training in PA school at Saint Louis University, one of my instructors told our class that the most crucial part of an appointment is taking an accurate history and knowing what questions to ask. After this, you need to allow the patient to talk, because they will often give you the diagnosis.
Throughout my 10 years as a PA, I have used the skills I acquired in these two learning environments to encourage my patients to tell their story and chronicle the events that led up up their appointment.
During their story, I only interrupt at a minimum to verify my understanding while collecting pertinent details. When the story concludes, I typically only ask a few additional questions to fine tune an accurate history.
If I don’t have a diagnosis by this point, I’ve at least narrowed down to a handful of possibilities before conducting the physical exam and ordering labs, imaging and office procedures.
Make no mistake, I realize that listening is a skill that takes time, patience and practice to hone. As the provider, you must train yourself to quiet your thoughts and remain in the moment with the patient. Remember those seemingly insignificant details, because you often must make inferences and deductions. Lastly, you need to listen to what they are not saying.
This process takes a little longer than other methods. However, the clear benefit is that fewer delays are encountered while developing an accurate diagnosis. The end result is that the provider initiates an effective and appropriate treatment more quickly, which leads to better outcomes for the patient.
– KIM BREY, PA-C