Maxillofacial Surgery
Patient Interview and Consultation
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
12 sections · 78 slides
Overview
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- What we will cover
The first conversation
First contact, first impression, and the trust everything else rests on
- Why the first meeting decides so much
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- A structured conversation, not an interrogation
- A clinician and patient in conversation
The presenting complaint
Getting the real reason out of the patient, in the patient's own words
- Start with the complaint — gently
- Three kinds of question
- Open, closed and leading questions
- Attentive listening — what it looks like
- Your body speaks louder than your words
- The Chinese character for 'listen'
- Aesthetic, functional, or both
History of the complaint
How long it has troubled them, and what changed to bring them here
- The question that matters: why now?
Empathy
What the word means, where it came from, and why patients feel its absence
- What empathy actually means
- Where the word came from
- A poet's definition of empathy
- The poet who longed for empathy
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- Becoming the wounded person
- One body, many limbs
- Empathy alone is not enough
- Kindness in the consulting room
Taking the history well
Turning a rambling account into an accurate, ordered record
- Patients do not tell the story in order
- When to write the notes
- Four tasks in every good consultation
- The four tasks, in words
The psychosocial history
Five things to judge before you agree to treat anyone
- Why the psychosocial history exists
- Where post-treatment unhappiness comes from
- Five things to evaluate
- The five, in one line each
- Perception: does it match yours?
- When to refer for a psychological opinion
- ~1 in 4
- One remark can colour the whole interview
- Guarding against your own snap link
- Motivation: from inside or from outside?
- Two kinds of motivation
- Expectations must be realistic
- Never over-promise
- Cooperation: can they see it through?
Risks, costs and shared decisions
Saying the difficult things before treatment, not after
- Say it before, not after
- 'Cost' does not only mean money
- The two halves of treatment cost
- Shared decision-making
- Why shared decisions are difficult
- Treatment burden
- How clinicians accidentally bias the choice
- What 'true consent' means
- Support network: bring the family in
- When the family is against it
- A relative at the bedside
Medical history and records
The questionnaire, the double-check, and the written record
- Taking the medical history
- What matters most in facial deformity
- Before the patient leaves the room
Danger signals
The 'problem' patient, and why treating them helps nobody
- Why the 'problem' patient matters
- Sir William Osler
- Saying no, without offending
- Aristotle on the physician's role
- Danger signals: the patient's profile
- Danger signals: how they behave
- Tardy's red flags: the indecisive patient
- Tardy's red flags: the rest of the list
- SIMON
- The young male rhinoplasty patient
Closing the consultation
Records, leaflets, thinking time, and the second interview
- What happens after the first visit
- From first visit to decision
- The second interview
- The bottom line
Takeaways
What to carry into your next clinic
- Takeaways: the conversation
- Takeaways: judging the patient
- Takeaways: safety net
- References
- References (continued)
- References (continued)
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition