A consultation is the first meeting with the doctor.  It normally involves a discussion of the patient’s problem (taking the history) and an initial physical examination.

The patient will be brought from the waiting room into a consultation room and will be asked to disrobe from the waist down and to wrap a disposable paper drape around their waist.

After the patient has changed, the doctor will enter the examination room and sit down on a chair and begin a discussion with the patient.

Sometimes the specialist will receive documentation about the patient’s problem ahead of time and that will be available to the specialist at the initial consultation. Sometimes there will be nothing other than the reason for referral.  Lack of documentation does not mean that the referring doctor is not as good as one that sends information.  Referral patterns vary amongst family physicians and sometimes a doctor who is superb at identifying a medical problem may be a poor letter-writer.  In any case, for most specialists with experience, many of the referral documents are unnecessary, and often quite incorrect if they include presumptions about the diagnosis.  Even if the patient does present with documentation about their problem, the Pezim Clinic specialist will usually like to hear the patient describe it in their own words.  Documentation can be obtained later or will sometimes materialize during the interview if required (thanks to a persistent receptionist who will contact the referring physician’s office).

The physical examination will entail a general assessment that relates to disease of the abdomen.  A simple rigid sigmoidoscopy is usually included in this examination, but bowel preparation is not necessary and, in fact, is discouraged since it can alter findings on sigmoidoscopy.

An assessment of the problem will be given to the patient and potential diagnoses discussed.  If further testing is recommended, the goals and risks of the treatment will be explained.  At the end of the meeting, the patient can arrange for further testing by speaking with the receptionist.

© Pezim Clinic, Vancouver, British Columbia, Canada