If a patient presents three times with the same symptoms or concerns, particularly if symptoms unexpectedly persist, escalate, or remain unexplained, it’s time to rethink.
- Reflect: Think back on what the patient has said and consider what has changed or been missed. Offer ongoing continuity of care with follow-up. If previous consultations have been remote, see the patient face-to-face and conduct a physical examination.
- Review: Where underlying uncertainty exists, consider seeking a view from a peer and review any red flags that may suggest another diagnosis, regardless of the patient’s age or demographic.
- Rethink: If appropriate, refer onwards for further tests or for specialist input.
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