GP Stage 3 Simulated Consultation - Healthcare Professional 7
You are an SHO on an acute medical ward. Hannah, one of the domestic workers who you know well has asked to speak to you during your lunch break.
You are Hannah, one of the domestic workers on the medical ward. You have arranged to meet one of the junior doctors on the ward to discuss your father’s health. Your father was recently admitted to one of the other medical wards after reporting worsening lower back pain and urinary retention (inability to pass urine). In particular, you would like to discuss the report of your father’s recent CT Spine.
CT Whole Spine Summary
There are extensive spinal metastases of likely prostatic origin. Specialist input recommended.
You are bewildered why the ward doctors have involved the palliative team, as it is not as if your ‘father has cancer or something serious’. You would like the junior doctor to explain to the medical team looking after your father that they are confused, and should ‘just prescribe dad antibiotics’.
You have been working in the hospital for 15 years, and as a result you feel that you have a good level of medical understanding.
If advised by the doctor that this report suggests that your dad does have cancer, you remain in denial insistent that this cannot be true since he is ‘still young’ and ‘otherwise healthy’. Your mother also had cancer (advanced ovarian), and she was completely bedbound as a result, passing away within 6 months of diagnosis. Given that your father is relatively well, you do not believe that his diagnosis may also be cancer.
At home, you live with your father and have done so for your whole life. You became very depressed when your mother passed away 6 years ago, and worry about losing your father as well.
This is an extremely challenging consultation, made more difficult by the relative’s perception of having a firm medical background. Whilst providing direct medical advice is not recommended, ignoring the issue altogether would also be seen as insensitive. The best candidates will advise that the report is consistent with cancer, exploring the psycho-social implications of this, as well as advising/arranging a meeting with the responsible medical team for further clarification of the diagnosis and management plan.