controlling the patient interview

That drives me up the wall when they tell you they stopped taking their water pill because mom's cousin's sister's neighbor had a real bad experience with wetting themselves and they don't want to end up like their great aunt Shirley who was in adult diapers because she couldn't control herself. I just try to ask as many "yes/no" questions as possible and when they start getting off track, restate the original question. I'll also kindly alert the doc that pt in room 2 is a talker so they can be prepared. We have some regulars that are known talkers and we have a signal with the front desk to pull us away for an "urgent phone call" if needed.

You are in control of your time.

There is already an acknowledgement that certain individuals are 'talkers' and will waste your time if allowed.

Have a very specific plan in mind before you enter the room.

Politely interrupt and redirect the patient when necessary.

Sometimes our elderly have a difficult time consolidating thought and discerning important rather than trivial detail relative to their health status. When you know that such is the case, ask those patients very specific questions about probable causes/reasons for a visit.

As mentioned before, yes/no questions will work best in those cases.

Good luck!

I know exactly what your are saying, Ive had some of the same issues. I sometimes nicely tell me to answer my questions briefy because the MD will speak to them in details latter on. So before I even start asking questions, when I notice this patient is gna give me a hard time I ask them to answer in a brief statement.

Thanks to all and to all the suggestions on keeping a basic patient triage to as short a time as possible. I had been using several of the tips mentioned (YAY on my part!) but it was good to get the back up from those of you in the same boat or with more experience-feel like I am on the right track. The biggest help so far has been to ask them to tell me their main problem today in just a few words "the doctor/NP will review and discuss this with you in much more detail; I just need a few notes so the doctor knows where to start." Boy, does that help and it is the truth.

The part that is still slow going is the med review-we ask patients bring in all their medications but that can be inconvenient. Some will bring in a list. Even with the meds there in front of you, you find out they've only been taking something once a day instead of twice or twice instead of once or prn instead of daily. You just want to hug to death those with a complete list and taking as directed!

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Thanks to all and to all the suggestions on keeping a basic patient triage to as short a time as possible. I had been using several of the tips mentioned (YAY on my part!) but it was good to get the back up from those of you in the same boat or with more experience-feel like I am on the right track. The biggest help so far has been to ask them to tell me their main problem today in just a few words "the doctor/NP will review and discuss this with you in much more detail; I just need a few notes so the doctor knows where to start." Boy, does that help and it is the truth.

The part that is still slow going is the med review-we ask patients bring in all their medications but that can be inconvenient. Some will bring in a list. Even with the meds there in front of you, you find out they've only been taking something once a day instead of twice or twice instead of once or prn instead of daily. You just want to hug to death those with a complete list and taking as directed!

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Patient compliance with medications is an enormous issue that is often not adequately addressed in your setting. You and I know why, it is frequently the annoying mess that you describe.

I like to provide my patients with a current list of their medications and the instructions for use. This is part of my service to them and most software charting systems allow a printable form which makes it easy. Helping people to correctly interact with their medications will improve health outcomes, in my view.