Consultation guides for medical students and doctors
First moves and lines for the patients who derail a history, and how to get more reps. Each guide has the evidence and a patient to practice on.
Difficult patients
| Guide | First move | Say | |
|---|---|---|---|
| Angry patients | Name the feeling and its reason before you touch the complaint. | “Two hours, still bleeding. That would make anyone angry.” | Practice |
| Talkative patients | Let them finish the opening, then summarize and agree on an order. | “Can I check I’ve understood so far?” | Practice |
| Shy patients | Ask one open question, then hold the silence longer than feels comfortable. | “What else has been hard lately?” | Practice |
| Difficult patient types | Spot which of six types you’re facing. Each one tests a different skill. | “What have you read about this? I’d like to know what you’re weighing up.” | Practice |
Getting good faster
| Guide | The point | This week | |
|---|---|---|---|
| AI doctor vs AI patient | AI doctors answer your questions. AI patients make you ask them, and asking is the skill. | Take one history from an AI patient before you ask a chatbot for the answer. | Practice |
| Clinical experience | Count the patients you talk to and the feedback you get, not hours. | Take full histories instead of watching, and ask for one specific piece of feedback on each. | Practice |
| Becoming a good doctor | Patients judge whether you listened, explained what happens next and checked they understood. | Tell the patient what happens next at each step, then check they understood. | Practice |
| Rare cases | Train the habits that catch zebras: red flags, stories that don’t fit, the unlikely question. | Read one case report a day with the ending covered, and write your differential first. | Practice |