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Independents' Day

10 tips for dealing with investigations

David Haslam is a PMETB board member and former RCGP chair

David Haslam is a PMETB board member and former RCGP chair

1 Before ordering any investigation, think: 'What will I do with the answer?'

2 If all you would do is file a result, don't do the test.

3 Make sure you know the results of tests that you order ­ as you are a registrar the results may not come back to you personally, so keep a checklist.

4 Make sure patients understand how they should get their results. It is a disaster if an abnormal result is filed and ignored.

5 I enter all scans and X-rays in a diary file on Microsoft's Outlook Calendar software on the date that I expect a result to come back, so I don't forget to make sure the patient knows the result.

6 Explain to patients what results mean. 'Your blood test is normal' can mean different things to different people.

7 Beware of leading patients to think that if their blood test is normal, that means you don't believe their symptoms are genuine.

8 Beware of being over-reassured by normal investigations. Remember, 80 per cent of diagnoses come from taking the history, 16 per cent from examination, and only 4 per cent from investigations.

9 If you are referring a patient for an endoscopy or other hospital investigation, an information sheet can help to dispel some of the inevitable anxiety about the procedure.

10 If you aren't sure what investigations to use, speak to the department concerned. You are requesting a service and opinion as you would from any other specialist you use, not issuing an order.

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