I reviewed everything. I tried to listen, even though I was familiar with the story. I was sure to have the patient disrobed and gowned, never examining through clothing, and not interposing gloves to the process. I looked at her fundi. I palpated her thyroid and listened over it for bruits. I was careful to touch and work all her joints. I watched her walk. I brought the radiographs up on the computer screen and explained them to her. I emphasized to her my respect for my colleague and his skill, clinical acumen, and concern. We spoke until she had no questions. She then assured me that I had won her trust; she would return to my colleague with renewed confidence (just like she had previously promised at each visit with him…). Q.E.D.
Dr. Panush is professor of medicine, Division of Rheumatology, at the Keck School of Medicine, University of Southern California, in Los Angeles.
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