49. Taking a history 3 PROFESSIONAL ENGLISH IN USE FOR MEDICINE

PROFESSIONAL ENGLISH IN USE FOR MEDICINE

49. Taking a history 3

A	Reviewing the systems Once you know the main reason shy the patient wants medical attention, it is sensible to ask about the systems to determine the patient’s general state of health and check for any additional problems. The patient should be encouraged to describe symptoms spontaneously. Initial questions should be open-ended and as general as possible follow up with more specific questions if needed, but avoid putting words in the patient’s mouth. Open ended questions Closed questions √ What’s your appetite like? √ Have you eaten today? √ How’s your vision? √ Is your vision ever blurry?
B	Asking about the central nervous system √ Do you suffer from headaches? √ Do you get ringing in the ears? √ Have you ever had a blackout? √ Have you ever experienced any numbness or tingling in your hands and feet? √ What about fits? √ Do you have any problems sleeping? √ Have you had any dizziness?
C	Patient ideas, concerns and expectations It is important during the consultation to give patients the chance to express their own ideas and concerns about their problem and to determine what their expectations are. The letters ICE (Ideas, Concerns and Expectations) are a way of remembering this. Typical questions are Ideas √ What do you know about this problem/ condition/ illness? √ How do you think you got this problem? √ Do you have any ideas about this? √ What do you mean by ….? Concerns √ What are you worries about this? √ How might this affect the rest of your family? √ Do you have any concerns? Expectations √ What do you think will happen? √ What were you hoping we could do for you? √ What do you expect from me?
D	Phrasal verbs in history taking Phrasal verbs are often used in informal spoken English. Both patients and doctors may use them in consultations. A phrasal verb may have several meanings according to context.

EXERCISES

49.1	Match the numbered questions (1-7) in B above to the symptoms for the central nervous system (a-f). there are two questions for one of the symptoms. a headaches b hearing symptoms c faints d tingling (paraesthesiae) e fits f sleep patterns
49.2	Read the extract from a consultation. In the numbered questions (1-4), is the doctor encouraging the patient to talk about her ideas (I), her concerns (C) or her expectations (E)? look at C above to help you.
49.3	Complete the sentences with phrasal verbs. Look at D above to help you. 1 The headaches ____________ ____________ in the morning. 2 However much I eat, I don’t seem to ____________ ____________ any weight. 3 I’ve tried to ____________ ____________ smoking several times. 4 I’m so depressed I don’t feel I can ____________ ____________. 5 When I cough, I ____________ ____________ phlegm. 6 He thought he had stomach ache but it ____________ ____________ to be cancer.

Answer key