Transcript TALKING TO THE PATIENT AND FAMILY! While talking to the patient and their family… *Sit down and make eye contact with the patient and.

TALKING TO THE
PATIENT AND FAMILY!
While talking to the patient and
their family…
*Sit down and make eye contact with the
patient and their family.
Who am I ?
I am Dr._Name__. I am a _Kind of Dr._.
I am on the__ which_service ___ and I have been asked to do a
__type of test__. I wanted to come by and explain the __test__
to you.
Why?
I am here today to explain to you and your family:
1- what the procedure is
2- what the procedure isn’t
and basically try to answer any questions you have.
Review the journey
Just to review how things have gotten to this point, let me tell
you my understanding of how we have gotten here and you
correct me anywhere that is different from what you know.
You have now engaged the patient and assured him/her that
you understand the problem. He is listening to what you are
saying and now feels that he is being talked with instead to
talked at.
Discussion of exam
Basically when you went to _Dr. name___ for _reason___ a _kind of test__was done
along with other studies. The _test__ showed an area of_concern__ in the
___body part__that looked questionable / changed from __previous exam.
IF NO PRIOR EXAMS JUST SAY QUESTIONABLE
We now need to do another exam to determine if that region is truly
normal or a significant problem. That is what we are going to do with
the _kind of test_. If it shows something at that area, it can tell us it is
abnormal but usually can’t tell us exactly what is causing it. It can tell
us there are several possibilities and probabilities. So the first goal of
the _kind of test__is to determine if this area is real or significant and what
it most likely is.
Discussion of Exam
The problem is that we can’t base a plan on something possibly
being this or that….
I think right now the possibilities are:
1- an area of scarring
2- a region of infection
3- a type of tumor
Our plan of action will be different depending on what the area of
concern turns out to be.
Options
The options that we have now regarding what to do are:
1-- Observation
2-- Surgery
3-- Biopsy
Discussion of Options
Observation
One of your options would be to get a follow up study after a
few months and see if the area changes. If it doesn’t change
or gets smaller it is likely a scar and is best left alone.
The problem with this option is that if the area gets bigger we
have lost some time that we could have started treatment.
This is still a reasonable plan but this option requires time to
see if it is the best plan.
Discussion of Options
Surgery
A second option would be surgery. We can take it out,
find out what really it is and hopefully treat it at the same
time and be done with it.
The problem with this option is that all things don’t need to
go to surgery. There is a risk of surgery and the time for
recovery may have complications.
Again we solve the problem but we may find that you really
didn’t need the surgery anyway.
Discussion of Options
Biopsy
A biopsy is what we have been asked to do and it is some what
of a middle ground that tries to tilt the scale one way or the other to
determine if something is a scar and better left alone or a tumor
and best to go to surgery.
The way it works is using the _type of machine __for guidance the area
is located and a _small needle_ is directed into the area and a sample
of the tissue is taken through the needle.
Discussion of Options
Biopsy
We take a sample of tissue and let the pathologist look at it under
the microscope and basically tell us what is or what it is most
typical for.
The biopsy can try to answer the question without having to go
to surgery and would have less overall risk than surgery.
Discussion of Options
Biopsy
The advantage is it does not require stitches or an incision.
The disadvantage is it doesn’t take a large sample and sometimes
we can not get enough tissue in the needle to answer the question.
There is a risk of bleeding with any procedure using a needle
But the small size of the needle limits this.
We are doing this _test_ in a hospital and have the people here to
take care of any problems.
Questions?
I’m sure this is a world wind of information
for you and I will be glad to go over again
any of it that was not clear.