CCFP 105 Topics: Multiple Medical Problems

Written By: Vaishvi Patel, a fourth-year medical student from the University of Alberta Ronan Noble an MD/PhD student also from the University of Alberta Expert Review By: Dr. Henry Ma, PGY2 FM at UofA Objectives: In all patients presenting with multiple medical concerns (e.g., complaints, problems, diagnoses), take an appropriate history to determine the primary reason for the consultation. In all patients presenting with multiple medical concerns, prioritize problems appropriately to develop an agenda that both you and the patient can agree upon (i.e., determine common ground). In a patient with multiple medical complaints (and/or visits), consider underlying depression, anxiety, or abuse (e.g., physical, medication, or drug abuse) as the cause of the symptoms, while continuing to search for other organic pathology. Periodically re-address and re-evaluate the management of patients with multiple medical problems in order to: • simplify their management (pharmacologic and other) • limit polypharmacy • minimize possible drug interactions • update therapeutic choices (e.g., because of changing guidelines or the patient's situation) In patients with multiple medical problems and recurrent visits for unchanging symptoms, set limits for consultations when appropriate (e.g., limit the duration and frequency of visits).