Counseling and concluding the patient encounter:

• At the end of the history and physical, inform the patient about what you think is the reason for his symptoms.

• You do not have to give one specific medical diagnosis. You can discuss with him two or three likely differential diagnosis that you are considering. You can tell him that you need to run some blood tests and imaging before narrowing it down to one specific medical diagnosis.

• You will have to explain the nature of these tests to reassure the patient.

• You are expected to answer all questions that the patient has. If you are asked a difficult question, and don't know what to answer, tell the patient that, at this time you don't have more information on that question.

• Reassure him that when you see the test results, you or one of your colleagues will get back to him with more information.

• You can also tell the patient that you will get back to him after discussing with your attending physician.

• Before you end the encounter, offer a final chance for him to clarify any doubts he may have. "Do you have any other questions for me, Mr. smith?" is a good way of phrasing this.

• You can then conclude the interview by telling the patient "it was a pleasure meeting you".