ABFAS Patient Communication Skills 3

Question 1

A patient asks why the surgeon recommends a total ankle replacement instead of ankle fusion. The patient read online that fusion has better long-term outcomes. What is the ideal response?

Accepted Answer

Acknowledge the patient's research, discuss the evidence for both options, and tailor the recommendation to the patient's specific situation

Answer

Discourage online research and explain that the surgeon's recommendation is most reliable

Answer

Defer the decision entirely to the patient since they have done their own research

Answer

Order additional imaging to justify the recommendation before responding

Question 2

Prior to a calcaneal osteotomy, a patient asks about the surgeon's personal complication rate. What is the best response?

Accepted Answer

Share your personal outcome data honestly and place it in context with published benchmarks

Answer

Decline to answer as personal outcome data is confidential and proprietary

Answer

Provide published literature complication rates and deflect the personal question

Answer

Tell the patient complications are rare and that they should not be concerned

Question 3

A patient appears visibly distressed after receiving the diagnosis of Charcot neuroarthropathy. Which communication technique is most appropriate at this moment?

Accepted Answer

Allow a moment of silence, acknowledge the patient's emotional reaction, and ask if they want to continue the discussion

Answer

Immediately provide a detailed treatment plan to give the patient a sense of direction

Answer

Minimize the severity to reduce patient anxiety before discussing management

Answer

Hand the patient educational materials and schedule a follow-up to discuss the diagnosis

Question 4

During a pre-operative discussion, a surgeon uses terms such as 'dorsiflexory wedge osteotomy' and 'peroneal spastic flatfoot.' The patient nods throughout. What should the surgeon do?

Accepted Answer

Ask the patient to explain the planned procedure in their own words to confirm understanding

Answer

Assume comprehension since the patient did not ask any questions

Answer

Provide a written copy of the operative note template for the patient to review

Answer

Use a medical dictionary to help define any terms the patient may not understand

Question 5

A parent brings their 16-year-old for evaluation of a bunion and insists on discussing diagnosis and treatment without the teenager present. What is the most appropriate approach?

Accepted Answer

Examine and counsel the adolescent patient directly, then include the parent in a summary discussion

Answer

Discuss only with the parent since the patient is a minor

Answer

Defer to the parent's wishes entirely to maintain a cooperative relationship with the family

Answer

Refer the case to another provider to avoid the conflict

Question 6

A patient with a history of chronic pain syndrome reports that postoperative pain is far worse than anticipated after a flatfoot reconstruction. The patient is upset and feels their concerns were dismissed. What is the priority response?

Accepted Answer

Apologize for the distress, validate the patient's experience, review pain expectations, and discuss a management plan

Answer

Order imaging to rule out a surgical complication before engaging with the patient's concerns

Answer

Refer the patient to pain management immediately to avoid further conflict

Answer

Document that the patient was counseled preoperatively about expected postoperative pain

Question 7

A surgeon leaves a voicemail informing a patient that their biopsy result showed a benign lesion. The patient later states they never received the message. What is the most appropriate process improvement?

Accepted Answer

Implement a closed-loop communication protocol requiring documented patient acknowledgment of all result communications

Answer

Have the patient sign a form acknowledging they are responsible for retrieving messages

Answer

Use email as the primary method for delivering biopsy results going forward

Answer

Leave a second voicemail and document the date and time in the medical record