Assessing patients clinically through taking the history and performing a physical examination provides the basis for safe and effective clinical practice. Doctors new to general practice can find it difficult to undertake an effective clinical assessment in under 10 minutes, while not missing serious illness. This article outlines strategies for assessing patients in a focused yet patient-centred way and discusses areas that can be particularly difficult.
Get full access to this article
View all access options for this article.
References
1.
Borrell-CarrióF.EpsteinR.M.Preventing errors in clinical practice: a call for self-awareness. Annals of Family Medicine (2004) 2: p. 310–6
2.
ChanW.S.McGladeK.Patients' attitudes to GPs' use of computers. British Journal of General Practice (2003) 53: p. 490–1
3.
ChanW.-S.StevensonM.McGladeM.Do general practitioners change how they use the computer during consultations with a significant psychological component?International Journal of Medical Informatics (2008) 77: p. 534–8
4.
FaheyT.van der LeiJ.Producing and using clinical prediction rules. In: The evidence base of clinical diagnosis: theory and methods of diagnostic research (2nd edition) KnottnerusJ.BuntinxA. F. (eds) (2008) Blackwell Publishing ISBN: 9781405157872
5.
FreemanG.K.HorderJ.P.HowieJ.G.R.Evolving general practice consultation in Britain: issues of length and context. British Medical Journal (2002) 324: p. 880–2
6.
HeneghanC.GlasziouP.ThompsonM.Diagnostic strategies used in primary care. British Medical Journal (2009) 338: pp. b946
7.
HowieJ.G.R.HeaneyD.J.MaxwellM.WalkerJ.J.FreemanG.K.RaiH.Quality at general practice consultations: cross sectional survey. British Medical Journal (1999) 319: p. 738–43
8.
HowieJ.G.PorterA.M.HeaneyD.J.HoptonJ.L.Long to short consultation ratio: a proxy measure of quality of care for general practice. British Journal of General Practice (1991) 41: p. 48–54
9.
JonesR.LatinovicR.CharltonJ.GullifordM.C.Alarm symptoms in early diagnosis of cancer in primarycare: cohort study using General Practice Research Database. British Medical Journal (2007) 334: p. 1040
10.
MontgomeryA.FaheyT.A systematic review of the use of computers in the management of hypertension. Journal of Epidemiology and Community Health (1998) 52: p. 520–5
OkkesI.M.OskamS.K.LambertsH.The probability of specific diagnoses for patients presenting with common symptoms to Dutch family physicians. Journal of Family Practice (2002) 51: p. 31–6
13.
PantingG.How to avoid being sued in clinical practice. Postgraduate Medical Journal (2004) 80: p. 165–8
RoterD.L.HallJ.A.Physicians' interviewing styles and medical information obtained from patients. Journal of General Internal Medicine (1987) 2: p. 325–9
16.
SackettD.L.RennieD.The science and the art of the clinical examination. The Journal of the American Medical Association (1992) 267: p. 2650–2
ScottI.Errors in clinical reasoning: causes and remedial strategies. British Medical Journal (2009) 339: p. 22–5
19.
SilvermanJ.KinnersleyP.Doctors' non-verbal behaviour in consultations: look at the patient before you look at the computer. British Journal of General Practice (2010) 571: p. 76–8
20.
SummertonN.Making a diagnosis in primary care: symptoms and context. British Journal of General Practice (2004) 54: p. 570–1
ThistlethwaiteJ.MorrisP.The patient-doctor consultation in primary care: theory and practice (2006) The Royal College of General Practitioners ISBN: 9780850843071
