Today we repeated the history scenario from two days ago of a teenager with coeliac disease who has gone for a yearly review. For the past six weeks she has had abdominal pain and loose stools.

The history was more comprehensive do we missed out a few points and also the discussion could have been better.

The Learning points are:

• Develop differential diagnosis while reading the information – outside.
• This will give a frame work to ask questions
• Opening statement is vital to a good start.

A little like the OPENING batting score in a cricket match. Good score – good rapport – less anxiety and better for things / questions – players – to follow.

• Focused history vs Long case. In the long case – do not know the patient hence all parameters in details where as in FOCUSED history lot of information provided with an ‘acute’ deterioration – that NEEDS to be followed through.
• ‘Non compliance / Cheating on diet’ / medications needs EXPLORING – WHY – and NOT just a passover.

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“Hello Toby, Thank you for coming – i am Dr X. Have you come alone?

We have not met before but from your notes / letter from GP – I have gathered you have .XYZ

How can I help?