Component of a simple consultation

Dr K K Aggarwal
National President IMA and Dr Vijay Agarwal

ACTIVITY	Actions Required	Charges INR
Registering a patient	Capturing demographic details Noting allergies Noting other alerts Storing of data for 3 years (MCI) / 7 Years (Income Tax) Electronic health record keeping (CEA Rule 9)
Consultation Professional conduct, Etiquette and Bioethics	A: Acknowledge patient and introducing yourself L: Patient listening E: Detailed explanation R: Revision in patients own words T: Thanking the patient
History taking	Detailed history taking Making a summary of past voluminous records
Examination	Ensuring privacy & confidentiality; Undressing and examination; Hand washing before and after examination.
Investigations	Planning, Counseling and Documenting
Treatment	Making provisional diagnosis; Writing detailed prescription as per MCI code of ethics. Treatment counseling
Counseling	Diet Mental Fitness Pharmacy Sexual Health Vaccination
Rehabilitation	Exercise Job Vacations
Notification	Notifiable Diseases Communicable Diseases Adverse Reactions Medico Legal Cases Sentinel Events Antimicrobial Resistance Drugs/Devices/Vaccines/ Herbs/Blood reactions
Certificates	Leave, fitness, rest etc.
Consent	Consent Informed refusal Video Consent
Skilled Maneuvers Physical Mental	1, BP in all four limbs 2. Tourniquets test 3. Carotid massage test 4. Epley maneuver 5. Cold pressor test 6. Valsalva test 7. Fundus examination 8. Brain stem reflexes 9. Cognitive functions 10. Risk stratifications 11. Filament neuropathy check 12. Per rectal exam 13. Per vaginal exam 14. Pap Smear 15. FNAC 16. Oral smear 17. Potency testing 18. torch tests for hydrocele 19. Stethoscope test for conductive deafness 20. PAPA. CHACHA, KAKA test
Skilled Procedure Physical Mental	Dressing ( Small, Medium, Large, Special) Removing Foreign Body Gastric Suction Pharyngeal/ Laryngeal Suction
Point of Care Investigations	ECG Blood Sugar SPO2 PEFR Pocket Spirometry Noise Pollution Check PM 1, 2.5, 10 levels CO Monitoring Autonomic functions Driving fitness testing Hb Urine spot test Point of care blood tests ( dengue, malaria, typhoid, chikungunya) Bence jones protein screening test
Observation / Monitoring  if Required (hours)	First dose of drug Syncope Breathlessness Hypotension Allergy reaction After injections
First Aid	Oxygen ( per hour) Nebulization CPR Other first aids Injection Cast Plaster Sling Foreign Body removal