I |
Feel well |
Rule out no illness |
FP1 |
Delivery of bad news |
TN1 |
Explain the concept of negative results as well as false negatives and the uncertainty of the doctor |
Explanation of the limits of medicine |
Shared decision-making process for the next steps |
Explain how to remain healthy |
Partnership in the management of the disease |
II |
Feel well |
Rule out illness |
TP2 |
Delivery of bad news in a different relationship with the patient |
FN2 |
Discuss the limit of screening test |
Sharing the limits of screening test |
Encourage and monitor regular screening tests if appropriate |
Conducting tests for the final diagnosis |
Repeat the screening within the next interval if appropriate |
III |
Feel ill |
Rule out disease |
TP1 |
Patient and doctor agree on the disease discovered |
FN1 |
Conduct new tests for the final diagnosis |
Providing proper treatment |
Prevent and identify adverse events |
If the test is negative, no treatment actions are necessary |
If further testing is useless, introduce palliative care |
IV |
Feel ill |
Rule out no disease |
FP2 |
Sharing the limits of the test asked under pressure of the patient |
TN2 |
Empowering with protection against overtreatment |
Discussing further testing while protecting against overscreening |
In-depth communication about the subjective feeling of illness |
Explain doctors’ ignorance regarding inexplicable human suffering |
Be careful about false negatives (missed diagnosis) |
Master your own anxiety, the following standard guidelines about emotionally demanding patients |
Use time and trust to maintain a healthy doctor-patient relationship |