I have to remind myself to ask clear-cut, open-ended questions when examining patients. This is what I was taught to do in medical school, and I think I need a refresher.
I was reminded of this again while examining an adolescent patient. She had been a patient for many years so I knew her quite well. With the new electronic medical records I am using I find that I am not always making eye contact while I ask questions. It was far easier before…I wrote down my notes now I type them, then head to a different screen for medications, updates etc. making this a bit more cumbersome with less eye contact - surely there is a better way! At any rate, I knew this young woman had been taking birth control pills and I wanted to add this to her current medications, so I asked “are you still sexually active?” without really looking up (which I should have done!).
She suddenly says emphatically and loudly, “Dr. Sue, I am not promiscuous, you know I am only having sex with one partner” (long pause) “how could you call that sexually active?”
Point well taken! Not only did I not make good eye contact when I was talking to her (which I think is rather rude on my part), I asked her a question in “doctor talk” rather than using something less formal. She was correct, I would not consider her “active”, which she thought was synonymous with “promiscuous”.
She was an older adolescent who was smart enough to be using contraception while she was having sex with one partner. After clearing up the “active” part she also informed me that her partner was also wearing a condom to prevent transmission of infection. She had done everything correctly by coming to me prior to having sex and discussing contraception and disease prevention.
Once again I find myself learning from my patients and I have never used that “sexually active” statement again. That encounter did make me laugh throughout the rest of the day.