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What do you say in this situation?


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PA student currently doing rotations and have ran into this situation a couple of times. 

You walk into the room to see your next patient and you recognize them (could be your neighbor, someone that works out at your gym, a cashier at a store you frequent, etc) and they have a touchy complaint (Gyn, psych, etc) .... how do you handle these types of situations to make it not awkward?

You both recognize each other and the patient is embarrassed. As always, you are professional and HIPAA compliant, but how do you ensure to your patient this is the case? Do you have a canned statement? Don’t have a lot of experience with this but I have been in some rather awkward situations over the past few months.

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"Hi, Dave (everyone has a friend named Dave, right?)...  Before we get started, I wanted to make sure that 1) you knew you'd be seeing me today, and 2) You're comfortable sharing your concerns with me today, knowing that we know each other socially."

If necessary, follow up with "You wouldn't be the first acquaintance that I've had to treat, and yes, keeping secrets is part of my job.  Thing is, you wouldn't believe what else I know about people you might also know... and you won't get a chance, because I won't tell you.  This isn't a job for gossips.  However, if you're still not comfortable with that, I will go find another clinician to see you"

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I introduced myself (we recognized each other but didn't know names) yada yada gave my spiel about the shared visit and said if you're not comfortable seeing me I totally understand and won't be offended, just let me know.

At the end of the day, I want the patient to be comfortable and to be able to get everything from their visit.  On occasion I've done the visit, presented/gone back in with my doc, and at the very end the patient will ask to speak to the doc/SP privately - it's never ANYTHING about me but something they wanted to discuss with someone they had a stronger relationship with.  

I always keep in mind how I would feel as a patient and let that guide the interaction.

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