Reference no: EM133664682

Please review the case study linked HERE and answer the questions below with support from either the text or our class discussions, where needed.

Questions:

1. Describe two barriers to effective communication seen in this case.

2. How could communication have been improved in the two examples you described above?

3. In your opinion, does the responsibility for the missed communication (regarding the patient's high blood pressure reading) fall with the medical student or the attending physician? -- and please explain why.

Case Study:

Communication PH 4250 Robert, a 56 year-old male with a history of diabetes and obesity, is visiting his primary care physician for a well check appointment. A medical student rotating through the clinic is the first to see Robert and asks how he is feeling. Robert says he is "doing OK" but complains of recurring headaches and fatigue for the past several weeks. The medical student takes Robert's vitals (temperature, pulse, blood pressure, etc) and does a thorough exam. The physical exam is relatively normal, aside from an elevated blood pressure of 170/92. The information from a student's exam is usually presented to the attending physician, but Robert's physician (Dr. Miller) has had a busy and stressful day and she is running behind schedule. Dr. Miller walks into the room without hearing the medical student's report. She briefly greets Robert and informs him that she is running behind with many patients waiting. Without sitting down, she runs through Robert's list of medications and asks what he needs refills on. Dr. Miller then performs a quick, routine exam, knowing that the medical student has already completed this step. As Robert has been a long-time patient of hers with no change in medical history, Dr. Miller feels she can make up some time by keeping this appointment short. With her hand on the door, Dr. Miller asks if Robert has any questions. Robert starts to explain the recent onset of headaches and fatigue, but Dr. Miller interrupts, saying "you hadn't been taking your diabetes medication very reliably last time we met. We'll check your lab work = I'm guessing your blood sugar is elevated. Start taking your medication as prescribed and you'll feel better soon - we'll see you again in a few months." Dr. Miller then rushes to see her next patient.

Later that weekend, Robert visits an urgent care clinic for his persistent symptoms. His blood pressure is in a range that qualifies as a hypertensive crisis and he is sent to the Emergency Department for immediate care. When Dr. Miller is notified about this, she looks back at the notes in Robert's chart from his most recent visit and see the medical student's note about the elevated blood pressure.