A Few Crucial Pieces of Advice for New Clinicians

1) Always set an agenda: “What would you like to cover in our visit today, before we get into any detail – so we can plan our time.”

2) Always summarize what you understand of your patient’s symptoms, and don’t be afraid to ask “anything else going along with this feeling that I might have missed?” And never take self-diagnoses at face value. Ask for details.

3) Always explain your diagnostic thinking and always emphasize that symptoms can change and then lead to other conclusions or treatment choices. Don’t make snap diagnoses in a way that might seem arrogant or lazy.

4) Always spell out if you are adding a medication or making a substitution. We know hypertension and diabetes often require multiple medications as time goes by, but patients don’t (or don’t want to) understand that. Just the other day I learned that a diabetic patient stopped his pills when I asked him to start insulin!

5) Always make a followup appointment, especially if you just made a new diagnosis and treatment plan – just to make sure your diagnosis was correct and that your chosen treatment works. I have found that “call and let me know if this isn’t working” often leads to less than perfect outcomes and less than happy patients.