- •Kursk state medical university
- •V.I. Narolina, I.F. Shamara
- •Communication in doctor’s profession Kursk – 2008
- •Государственное образовательное учреждение
- •Содержание contents
- •Предисловие
- •Методика работы с учебным пособием
- •Рекомендации студенту
- •Unit I. Discussing the medical profession
- •Раздел I. Беседуем о профессии врача методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Speech Patterns:
- •My Future Profession
- •Not only by the Drugs
- •Becoming a Doctor Pre-reading
- •What Happens at a Medical School
- •Task 2. Summary Writing
- •Task 3.
- •Task 4.
- •The pediatrician
- •Case history
- •The physician
- •Case history
- •The surgeon
- •Case history
- •The general practitioner
- •Case history
- •The doctor in the Third World
- •Case history
- •The intensive care doctor
- •Case history
- •The terminal care doctor
- •Case history
- •The doctor and the law
- •Alternative medicine
- •Case history
- •Unit II. Communication of a doctor with a patient
- •Раздел II. Общение врача с больным методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Adjectives:
- •General symptoms:
- •Doctor-Patient Interaction Asking the Patient about the Present Illness
- •Physical Examination of a Patient (Giving commands)
- •Additional / Further Examination & Treatment Laboratory and Instrumental Studies
- •Consulting Specialists
- •Suggesting Hospitalization
- •Case History (Main Points)
- •Illness: described as to the time of onset, mode of onset, duration,
- •2. Nose, throat: running nose/caryzo/nasal cold ;sore
- •Enquiring into the Case History (Speech Models)
- •Pain characteristics
- •Intensity
- •E. Personal History:
- •Texts and dialogues At the Doctor’s Consulting Room
- •At the Polyclinics
- •Summoning a Doctor
- •Talk between a Mother (m), her Son (s) and the Doctor (d)
- •Examination of the Patient
- •Taking a Case History
- •Asking about the Present Complaints
- •Аsking about Pain Characteristics
- •At the Cardiologist’s
- •Asking about the Personal History & the Present Illness
- •System Review
- •Details of the Present Condition
- •Disorders Accompanying the Main Disease
- •Examining the Patient (Giving Commands)
- •Consilium on Investigations
- •Diagnosis and Treatment (Explaining to the patient)
- •Giving Advice
- •Unit III. Discussing the work of a hospital
- •Раздел III. Обсуждаем работу больницы методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns Polyclinics/Out-patient Department
- •Speech Models:
- •Medical Personnel
- •Paramedical Personnel
- •Junior Medical Personnel
- •Hospital
- •Verbs and Verb Combinations
- •Speech Models
- •Texts and Dialogues District Polyclinic
- •Interviewing the Doctor-in- Chief about the Work of the Polyclinic
- •At the Registry
- •District Doctor’s Work
- •District Doctor’s Working Day
- •Combined City Hospital
- •Interviewing the Doctor-in-Chief about the work of the Hospital
- •Work of an In-Patient Department
- •Visiting an In-Patient
- •Unit IV. Discussing the work of a chemist’s shop
- •Раздел IV. Беседуем о работе аптеки методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Drug Classes
- •Verbs and Verb Combinations:
- •Speech Patterns
- •Texts and Dialogues At the Chemist’s
- •Medicines and Medical Commodities
- •Voltaren
- •Indications
- •At the Ready-Made Medicine Department
- •At the Prescription Department
- •At a Hospital Chemist’s
- •At the University Chemist’s
- •Unit V. Discussing national health services in russia, usa, uk
- •Раздел V. Обсуждаем организацию систем здравоохранения в россии, сша, великобритании методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Public health institutions list
- •Management in preventive medicine (medico-sanitary) work
- •Texts and Dialogues Medical Service in Russia
- •An Interview on Medical Service in Russia
- •The National Health Service in Great Britain
- •Practitioner Services
- •Family Doctor Service
- •Professional Training
- •National Health Services in the United Kingdom
- •Medical Service in the usa
- •Health Services in the usa Situation for intercultural communication: a Russian doctor comes to the usa for a tour and speaks to an American guide about the problems of health services in the usa
- •Unit VI. Discussing scientific aspects of medicine
- •Раздел VI. Участвуем в научном общении ученых-медиков методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns Scientific Knowledge
- •Adjectives:
- •Speech Models
- •Rendering a Scientific Paper
- •Discussing an Article Starting the Сonversation
- •Discussing the Contents
- •Making Things Clear
- •Impressions
- •Closing the Discussion
- •Opening the Discussion
- •Conducting the Conference
- •Closing the Conference
- •Presenter Giving his Paper (Report)
- •Some Words Linking Ideas
- •Interaction between the Participants and the Speaker after his Report Participants Addressing the Chairman and the Speaker
- •The Speaker’s Replies
- •Some Notes for Speakers
- •Fragments of Scientific Correspondence
- •Appendix I
- •Speech Models
- •Size, Shape, Colour, Texture Characteristics
- •Speech Models
- •The Human Body
- •Speech Models
- •Muscular-Skeletal System
- •Cardiovascular System
- •Аррendix II
- •Physiological Processes and Changes
- •Приложение II
- •Описание физиологических процессов и изменений
- •Speech Моdels
- •Appendix ііi General Symptoms and Adverse Reactions: Приложение ііi
- •Пожелание студенту
- •Список литературы
- •305041, Г. Курск, ул. К. Маркса, 3.
- •305041, Г. Курск, ул. К. Маркса, 3.
Examination of the Patient
Before treating the patient it is necessary to make a correct diagnosis of the disease and to determine its aetiology, i.e. the causes of the disease. The doctor must know well the pathogenesis of any disease, i.e. the way and mechanism of its development, as well as the symptoms by which it can be revealed.
A number of different procedures is used to establish a diagnosis: history- taking, physical examination, which includes visual examination, palpation, percussion, auscultation, laboratory studies, consisting of urinalysis, blood, sputum and other analyses; instrumental studies, for example, taking electrocardiograms or cystoscopy, X-ray examination and others. For determining a disease it is very important to know its symptoms such as breathlessness, edema, cough, vomiting, fever, haemorrhage, headache and others. Some of these symptoms are objective, for example, haemorrhage or vomiting, because they are determined by objective study, while others, such as headache or dizziness are subjective, since they are evident only to the patient.
Taking a Case History
Case histories are biographical accounts of a patient by his doctor containing all information about his past and present that helps the physician understand the patient's health problems. A patient is asked to give such an account upon his first visit to a doctor or admission to a hospital. If he comes with a specific complaint he will, of course, be asked to tell his symptoms, any treatment or medicine he is taking and how long he had the complaint. If he comes for a check up, the interview may begin with a series of more general questions about the patient's home, work and marital status.
When enquiring into the history, the physician must inform himself about the health of other members of the family (family history), paying particular attention to the incidence of tuberculosis, mental disease, malformations, metabolic diseases, and syphilis.
From the patient's statements, information should be obtained as to past illnesses (children's diseases, poliomyelitis, rickets, wounds, accidents, operations, internal diseases), his occupation (there may be reason to recommend a change of work), his habits (alcohol, smoking) and any venereal disease.
The history, consisting of the hereditary and family history, the personal history and the present complaint must be entered accurately on a case-sheet for the information of the physician and other investigators.
In most hospitals there is a form which includes, among other things, the special points about which questions must be asked, which depend on the specialty dealt with.
General symptoms, such as pronounced gain or loss of weight, continuously high temperature, pain, loss of appetite, disturbances of sleep, abnormal thirst, and digestive disturbances should be dealt with first, going on to the special symptoms afterwards. Questions about the special symptoms should deal with the individual systems (respiratory, digestive, urogenital, peripheral and central nervous systems, locomotor system, etc.). Examination begins after taking the history.