ATSI – CCE – Clinical Encounter Script

Here is a script you can use to cover the key extra points required to pass an ATSI Clinical Encounter. These add to the usual systematic approach to the problem(s) to hand. Please watch the 2 short videos below, where you can hear some first-hand advice.

  1. Start the consultation in a friendly and informal manner
  2. “Hi, I’m <first name>, one of the doctors here, how can I help?”
    • You might choose <Dr Smith>, but this is much more formal and not advised or required.
    • You using their first name and them calling you “Doc” would be typical.
    • Your introduction will yield the opening line clue – remember it – we will get back to it – first we must introduce ourselves.
    • You may need to vary the introduction based on context, but it works for most circumstances
  3. “Ok, so before we get to <opening line clue>… I’d like to get to know more about you.”
  4. “Is it ok if I call you <patient firstname>?”
    • “Yes” -> “Great”
    • “No” -> “No worries, I’ll call you <whatever>”
  5. In ATSI culture, people like to know where you are from, and where they are from
  6. “So, <firsname> is your family from this place?” (alt) “Is this your country?”
    • “Yes” – “How long have you lived here?”
      • “About 50,000 years Doc”
        • “That’s a lot longer than my mob!”
      • Now, perhaps, we are sharing a joke and the ice is broken
    • “No” – “Ok, how are you finding it here? Do you miss home?”
  7. Now reciprocate with a little information about you.
  8. “Thanks for giving me a bit of background. I’m from…”
  9. We are expected to flag Aboriginal Health Worker involvement so do that now.
  10. “Would you like to invite our Aboriginal Health Worker to join us?”
    • “Yes” -> “Ok, I’ll just go and grab them”
    • “No” -> “No worries, please let me know if anything I say does not make sense”
  11. “So, <firstname>, can you tell me more about <opening line clue>?”
    • This will yield the free information the role player is required to give
  12. Next, read back to the key features
  13. “Ok, so today you’d like us to have a look at <key feature 1>, <key feature 2>, … ?”
    • Note these key features – remember them – the readback will help
  14. Now we can proceed in the usual manner
  15. Somewhere in the consult
  16. Note the higher rates of chronic disease in ATSI people.
  17. Note the availability of 715 annual checkups.
  18. Note we can register for CTG to make medicines cheaper or even free
    • If they have a concession card PBS medicines are free
    • If they do not have a concession card, they pay the $6.80 concession price.
  19. Offer the extra ATSI vaccines (if appropriate)
    • BCG @ birth
    • Meningococcal B @ 2, 4, 12 months (+6 months for at-risk)
    • Extra pneumococcal 13V @ 6/12 and 23V at 4 years and 9 years
    • Influenza yearly indefinitely for > 6/12
    • Hep A @ 18/12 and 4 years
    • Pneumococcal @ 50 (13V), 51 (23V), 56 (23V)
    • Shingrix early @ 50 (2 doses 2-6 months apart)
  20. Consider the common problems in ATSI Communities

How To Introduce Yourself

In the words of some ATSI women:

In the words of some ATSI men: