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YOUR FIRST: heartsink.
Dr Chris Hall offers some advice on dealing with the various types of patient who fall into the heartsink category
There are as many types of heartsink patient as there are types of GP. The politically incorrect notion of the weeping middle-aged tissue- wringer is an unfortunate stereotype, for in truth, heartsink status is independent of age and sex (reassuringly I have yet to meet any paediatric heartsinks, though it may only be a matter of time).
You can be certain that somebody, somewhere, has authored a highly incisive treatise on the dynamics of what we shall call the `challenging consultation', but I doubt that beyond suggesting coping mechanisms, such research can be of much practical use.
Many GPs consider the heartsink patient to be part of life's rich tapestry - indeed, while preparing for the video component of the MRCGP examination the registrar may find his or her heart leaping with joy when Mr Vague sits down and unfolds his list of (current) ailments. How quickly that joy changes to weary resignation when the same patient graces your consultation room for the umpteenth time with the same intractable ailments. You open with `How are you?' only to be greeted with dough eyes and a familiar resigned shrug of the shoulders.
You try: `What can I do for you today?'
Bad mistake. `Dunno, where do I start?' is the usual reply.
A few hints then for a couple of common scenarios.
- Glaikit, wabbit and footering on the broo; RAB C PATTER MAKES OXFORD...
- Newspaper article from: Daily Record (Glasgow, Scotland) Macaskill, Jamie June 9, 1999 700+ words
...its first appearance, along with zorbing (a sport involving rolling down hills in a large transparent ball). A heartsink patient frequently complains to doctors of persistent but unidentifiable ailments. And a trustafarian is a rich young person...
- Patient data, early SARS epidemic, Taiwan.(Dispatches)
- Magazine article from: Emerging Infectious Diseases Hsueh, Po-Ren Chen, Pei-Jer Hsiao, Cheng-Hsiang Yeh, Shiou-Huei Cheng, Wern-Cherng Wang, Jiun-Ling Chiang, Bor-Luen Chang, Shan-Chwen Chang, Feng-Yee Wong, Wing-Wai Kao, Chuan-Liang Yang, Pan-Chyr March 1, 2004 700+ words
...an airplane (Figure 1B). Patient 9 did not fly with the four patients but had contact with them in...bacteremia also occurred in patient 9. One of the patients who received ventilator support (patient 2) had concomitant bacterial...
- Patients should cc the benefits of doctors' letters; Health Minister calls on...
- Press release article from: M2 Presswire February 12, 2007 700+ words
...bodies to support patient information programme...RDATE:12022007 Patients should be kept informed...be copied to the patient as of right...copying letters to patients in 2003, with an...April 2004. The PCT Patient Survey of 2005...revealed that 68% of patients (who had been ...
- Netherlands Patient Monitoring Devices Market Report Is Out Now.
- Press release article from: M2 Presswire October 23, 2007 700+ words
...2007-Research and Markets: Netherlands Patient Monitoring Devices Market Report Is Out...announced the addition of "Netherlands Patient Monitoring Devices Market Report" to their offering Introduction Netherlands Patient Monitoring Medical Equipment Market Report...
- Patients seem depressed: What should nurses do?
- Newspaper article from: Homecare Education Management September 1, 1997 700+ words
Patients seem depressed...identify symptoms A patient has begun to lose...role-play with the patient. The nurse could...Then tell the patient, eTell me what you...Varney says. "Patients will get it wrong...
- PATIENTS CAN ASK QUESTIONS, NO APPOINTMENT NECESSARY THE DOCTOR WILL E-MAIL YOU...
- Newspaper article from: Seattle Post-Intelligencer (Seattle, WA) Black, Cherie September 21, 2007 700+ words
...mail interactions with patients last month, accounting...nearly half of all of his patient interactions, he said. He routinely e-mails patients with a detailed explanation...encrypted e-mail to ensure patient privacy, said Marnee...it is offering some patients the chance to communicate...
- Patients' Perceptions of Physician-Assisted Suicide.
- Newspaper article from: Clinical Oncology Alert December 1, 2000 700+ words
...attitudes of terminally ill patients (most of whom have cancer...cohort of 988 terminally ill patients from six geographically disparate...within the United States and 893 patient-designated primary caregivers...1996 and July 1997. Of the patients, 60.2% supported euthanasia...
- Patients' perceptions of emotional support and information provided to family...
- Magazine article from: AORN Journal Majasaari, Hilkka Sarajarvi, Anneli Koskinen, Helena Autere, Sinikka Paavilainen, Eija May 1, 2005 700+ words
...develop tools for patient and family member...EFFECTS OF SURGERY ON PATIENTS AND THEIR FAMILY...being not only of the patient but also of his or...well-being of a patient in the hospital. (13-16) Patients who are undergoing...
