mymrcgp ©

Case 1



Candidate Information:


Barry Jones, Age 40

Last attendance: 22.1.2010 Chest Infection.

Current Medication: Amoxicillin 500mg tds. 21 capsules.

No known allergies






Actor Instructions:


You are a 40 year old man.


Information freely divulged

You were lifting some slabs a couple of days ago and felt a sudden pain in your left lower back. You have been taking paracetamol and ibuprofen regularly since and have been lying in bed.


Information divulged if asked

  • You are normally fit and well

  • You have no comorbid conditions

  • You are not taking medications and have no drug allergies

  • You have no family history of note

  • You smoke 20 cigarettes a day and drink 2-3 pints a week on the weekend.

  • You are self employed as a builder and you are worried about loss of income if you are unable to work.

  • You live with your wife and children aged 5 and 10,

  • Your concerns are that you have 'slipped disc'

  • You have no red flag features of low back pain

  • You expect an X-ray to investigate your back pain but will only volunteer this information if asked about your expectations. If not asked you will ask about this towards the end of the consultation when the doctor starts talking about your management options.


If the doctor explains in an empathetic way and is understanding of your concerns and explains the reasons why an x-ray is not needed you are happy with the outcome, if you do not feel the doctor is being understanding/empathetic or appears authoritarian/doctor centred you get frustrated and are not pleased with the outcome and demand to get a second opinion. If the doctor tries to involve you in the management options you would like a stronger anti inflammatory rather than co-codamol/something sedating so you can still drive and work-you say that you can go to work and supervise rather than doing physical duties.


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