{
  "abstract": "Patients often seek urgent evaluations for acute flares of chronic conditions (functional abdominal pain, low back pain, migraine headache, etc.), and often see physicians they have never met. This creates a challenging situation for both the clinician and the patient. Developing a trusting relationship during the initial encounter is essential for a successful outcome. Frequently patients lack an understanding of the biopsychosocial aspects of chronic conditions and may seek additional testing when these acute flares occur. To be successful in these visits, we have found that establishing rapport and a structured framework for categorizing and evaluating symptoms is essential.This interactive workshop will use clinical scenarios including irritable bowel syndrome and recurrent low back pain to illustrate how a 12 step framework can help the clinician approach these patients to establish trust, and ensure an appropriate evidence based care plan to address the patient‘s concerns and minimize unnecessary testing. In the workshop, participants will share challenges, stories and their own best practices when facing similar situations. Participants will also learn the essential steps for patients to understand and accept the biopsychosocial aspects of chronic conditions and how this is important to ensure trust that the evaluation has been adequate to rule out other serious conditions and that no additional testing is necessary. Additionally there will be the opportunity to learn how to help patients engage in effective self management of their condition.The workshop will be led by 3 faculty from the Mayo Clinic, which is best known as a tertiary care center, but also provides primary care to a local population of over 140,000 patients. The 3 faculty have over a century of cumulative experience in both inpatient and outpatient primary care and have frequently seen patients with flares of their chronic medical conditions. The patients often present with significant anxiety that something is being missed or additional testing is necessary. The implementation of the systematic approach is essential to ensure that unnecessary testing is minimized and patients leave the visit with a better understanding of the contribution of the psychosocial aspects of their disease. Prior workshops led by the faculty have been successful in engaging the participants through questions and shared experiences ensuring that the participants left with a better understanding and skills to allow them to establish rapport quickly with new patients and apply the framework to the management of acute flares of chronic conditions.",
  "authors": [
    {
      "affiliations": [
        "Mayo Clinic, Rochester, USA"
      ],
      "name": "Denise Dupras"
    },
    {
      "affiliations": [
        "Mayo Clinic, Rochester, USA"
      ],
      "name": "John Bundrick"
    },
    {
      "affiliations": [
        "Mayo Clinic, Rochester, USA"
      ],
      "name": "John Wilkinson"
    }
  ],
  "title": "067 Developing a trusting relationship at the first visit to minimize overtesting and overdiagnosis",
  "uid": "03f9a0e9-ab03-5854-9a61-2ce1033e9925"
}