When providing a written management plan for patients with chronic disease, place the plan in the patient’s hands. It should be in a larger font, with treatment changes or updates bulleted by chronic disease.

When you review the plan with the patient, don’t ask, “Do you understand?” Instead, say, “To make sure that I have been clear, can you summarize the plan for me?”

With a clear, simply written plan in hand, the patient can review it and ask questions, and not feel put on the spot to remember everything we clinicians tend to say rather quickly toward the end of the visit. — Gail Marion, PA-C, PhD, Winston-Salem, N.C (188-9)


These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.