Keys to a successful consultation by Alessandra Graziottin

Here's a quick look at Prof. Graziottin's best tips for a successful medical consultation:

For a successful consultation

• Listen carefully to the patient’s symptoms and complaints, whilst you’re taking the written medical history.
• Look at the patient’s eyes, with a gentle, welcoming, truth-worthy attitude.
• Focus on verbal and nonverbal messages with a caring attitude. This is key for a comprehensive medical perception of both the ongoing pathophysiology contributing to the current complaints and the emotional impact it has on the patient. 
• Don’t interrupt her after 45 seconds.
• Use simple words and pertinent, bright, easy-to-understand examples.
• Never say “impossible” whatever the symptom the woman is complaining about. A far better comment is: “I well understand how difficult it is to live with these symptoms ...” or “I well understand you” or “I feel how painful it is”: this empathic overture is useful and precious to create a trusting and collaborative atmosphere.
• Do not stare at the computer screen while you’re asking or answering sensitive questions.
• In my practice, a key part of the consultation is a very accurate physical examination (“reading carefully the body signs”); that is currently one of the most serious omissions in the medical practice, also in gynecology.

This type of consultation may take more than 15 minutes, but the reward is:

• A solid trust alliance with the patient
• A comprehensive clinical evaluation and a higher probability of a very accurate diagnosis
• A more precise reading of predisposing, precipitating and maintaining factors contributing to current symptoms or pathology.
• A timely reading of comorbidities
• Stronger adherence to the treatment plan
• More effective therapies, also in complex cases of persistent sexual dysfunctions, chronic vulvar pain, chronic pelvic pain, or pain after cancer treatments.

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