1.3. Interview Basics

Question 1

What is the difference between the Patient-Centered and Physician Centered Model?

Answer 1

Patient Centered focuses on pt needs, not a disease or what physician needs to ask.

• Engaged patient in larger role
• Obtain a more thorough and accurate history vs not interrupting patient or jumping to conclusions

Question 2

Why is effective communication essential in patient-provider relationships?

Answer 2

• More accurate and effective interviews
• Better clinical differential
• Increase patient satisfaction, understanding and recall
• Improve compliance and disease outcome
• Decrease medico legal complaints
• Actual savings in time
• More structure and control of difficult consultation
• Increase job satisfaction

Question 3

What is included in the subjective component of SOAP note?

Answer 3

What you learn by taking history:

-CC, HPI (OLDCAAARTS), ROS, PMH, PSH, Meds, Allergies, FH, SH (FEDTACOSSS)

Question 4

What is included in the objective component of SOAP note?

Answer 4

PE findings, including structural findings, lab and radiology data

Question 5

What is included in the assessment component of SOAP note?

Answer 5

Differential and what you believe is going on

Question 6

What is included in the plan component of SOAP note?

Answer 6

What you and the patient agree to do, along with including OMT performed. This is the MDM

Question 7

Briefly discuss the 5-step approach to patient centered interviewing

Answer 7

Model to diagnose and treat using 5-model which simplifies 10 systems:

1. Biomechanical model: MSK
2. Resp-Circ Model: HEENT (NT part), Cardiac, Resp
3. Neuro: HEENT (HEE part), neurology, Endo, Immune system
4. Metabolic-Energy: GI and GU
5. Behavioral: Psychsoc

Question 8

What is the difference between the Old Medical Model and the Patient-Centered Model?

Answer 8

Medical vs Patient Centered

• Pt role is passive vs. active (they ask Qs)
• Pt is recipient of treatment vs. partner in plan
• Dr dominates convo vs Dr works w/ pt
• Care is disease centered vs quality of life centered
• Dr talks most vs dr talks less
• Pt may/may not adhere to plan vs pt more likely to adhere

Question 9

How should patient education material be written?

Answer 9

6th grade level or lower, and including pictures/illustrations

Question 10

What is empathy in relation to a physicians occupation?

Answer 10

Capacity to understand and relate to patients illness, experience and emotions through showing concern and interest, both verbally and through facial expression
-Name emotion, understand, respect, support, explore

Question 11

What is empathy in relation to a physicians occupation?

Answer 11

Capacity to understand and relate to patients illness, experience and emotions through showing concern and interest, both verbally and through facial expression
-Name emotion, understand, respect, support, explore

Question 12

What is the AUDIT test for alcohol use?

Answer 12

AUDIT: Alcohol Use Disorder ID Test

• Better sensitivity than CAGE
• More Qs for DR to remember, somewhat difficult to score

Question 13

What is the CAGE questionnaire for alcohol use>

Answer 13

• Screen pt’s who drink more than 1 drink/day or drink a lot of weekend
• Anyone suggest you CUT back?
• are you ever ANNOYED when pple talk about your drinking?
• do you ever feel GUILTY about drinking?
• do you need a drink in morning to steady (EYE opener)

Question 14

What does the NIAAA considered low risk for women and men over 65?

Answer 14

Women: no more than 3x/day or 7x/wk
Men: no more than 4x/day or 14x/wk
-Shows only 2% of people who drink within these limits have AUD.

Question 15

What does FICA stand for in regards to spirituality and religion?

Answer 15

F: Faith and Belief
I: Importance
C: Community
A: Address in care or assessment plan

Question 16

What does SAFE stand for in regards to Domestic Violence?

Answer 16

S: stress/safety
A: afraid/abused
F: friends/family
E: emergency plan

Question 17

What is a “problem pertinent”, “extended”, and “complete” ROS

Answer 17

• Problem pertinent is limited to problems identified in HPI
• Extended covers an additional 2-9 systems
• Complete: covers 10 additional systems

Question 18

What are the 5P’s when taking a sexual history?

Answer 18

1. Partner
2. Practices
3. Prevention of Pregnancy
4. Protection from STI’s
5. Past History of STIs

Question 19

What does LGBTQIA stand for?

Answer 19

Lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual/allied

Question 20

What is Gender Identity Disorder now classified as?

Answer 20

Gender Dysphoria (DSM 5)

Question 21

What is a one way to do a very basic general sexual screening?

Answer 21

Do you have any concerns about your sex life?