Mnemonic: LED TO REASON
⭐️ Lead in: introduce yourself to the patient & identify the correct patient
⭐️ Explore: how much does the patient know so far regarding his / her condition
⭐️ Diagnosis
- Explain the diagnosis to the patient: based on history, physical examination and initial investigations
⭐️ Treatment/Procedure
- Propose a treatment / procedure to the patient (e.g. ODGS, colonoscopy, right below knee amputation)
- Indication of the treatment / procedure (e.g. to remove tumor, to identify the underlying cause of anaemia, to remove source of infection)
- How is it done? (e.g. including under local / regional / general anaesthesia)
⭐️ Options: discuss all the options other than the proposed treatment / procedure, including that of doing nothing
⭐️ Results:
- Explain likely outcome in terms of pain, mobility, work, diet and return to normal activities (e.g. usually patient will stay in the ward for how long?
- How long it takes?
- How fast the result is available?
⭐️ Eventualities, e.g., the possibility of needing to remove the testicle in a hernia operation
⭐️ Adverse events
- Examples e.g. myocardial infarction, stroke, pulmonary embolism, bleeding and specific organ damage, vomiting
- What can be done to minimize? (e.g. antiemetic agents for chemotherapy)
⭐️ Sound mind: ask if they have understood
⭐️ Open question: check if further clarification is needed
⭐️ Note: document everything discussed in the case note
