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- Written By:
- Vaishvi Patel, a fourth-year medical student from the University of Alberta
- Ronan Noble an MD/PhD student also from the University of Alberta
- Expert Review By:
- Dr. Henry Ma, PGY2 FM at UofA
Objectives:
- In all patients presenting with multiple medical concerns (e.g., complaints, problems, diagnoses), take an appropriate history to determine the primary reason for the consultation.
- In all patients presenting with multiple medical concerns, prioritize problems appropriately to develop an agenda that both you and the patient can agree upon (i.e., determine common ground).
- In a patient with multiple medical complaints (and/or visits), consider underlying depression, anxiety, or abuse (e.g., physical, medication, or drug abuse) as the cause of the symptoms, while continuing to search for other organic pathology.
- Periodically re-address and re-evaluate the management of patients with multiple medical problems in order to:
• simplify their management (pharmacologic and other)
• limit polypharmacy
• minimize possible drug interactions
• update therapeutic choices (e.g., because of changing guidelines or the patient’s situation)
- In patients with multiple medical problems and recurrent visits for unchanging symptoms, set limits for consultations when appropriate (e.g., limit the duration and frequency of visits).