I spend anywhere from 15 minutes to an hour with each patient of mine. When I finish with the process of history taking, examination and treatment advice and feeling relieved that the brain now can get a few minutes rest before the next problem comes in, the patient instead of taking my leave pipes in, ‘doc, one more thing, I forgot to tell you’ and proceeds to tell me the one more thing.
This one more thing often turns out to be the most important issue and it will make me rethink my diagnosis and the treatment I had advised! Also means reexamination and spending more time!
When this one more thing comes up which is not infrequent I have often felt like throwing my stethoscope at the patient. Have not done it though.