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Question:
How can a physician effectively use AIDETSM in 7 minutes or less?
Answer:
Good question. As a practicing emergency physician for over 20 years, I can appreciate the time constraints that we all have to work with. However, if you dissect the suggestions that I present and affix a time frame to them, they don't necessarily add time to your patient encounter. I have found that my efforts to provide a thorough explanation to emergency patients results in having them ask me less questions overall. To break it down:
- First impression: 90 seconds
- Middle: normal history taking and examination, followed by explanation of what happens next: same amount of time you usually spend, although you want to focus on providing clear explanations that are free of medical jargon.
- Strong ending:
- Typically, you already ask a patient if they have any questions. What I'm suggesting is how we phrase that to the patient. Using the phrase: "I want to make sure that I have thoroughly explained everything well to you. Based on what I've covered, what questions do you have?" That doesn't take but a few seconds to say, but it conveys it in a more genuine manor. If you indeed have been thorough in providing a clear explanation, the patient will usually state, "Thanks for being so thorough. You've already answered all of my questions." I get that a lot in the ED from patients.
- Reviewing the treatment plan also just takes a few seconds, as does asking the patient if they have buy-in.
- The final greeting: also just a few seconds.
Overall, I have found that I can fit it all into the "seven minutes" that you reference. It just takes relentless practice.
With best regards,
Wolfram Schynoll, MD FACEP
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