During our small group discussion on the case of RO, a 59-year-old construction worker, a specific

moment that highlighted the impact of accurate patient history on treatment outcomes was when we
analyzed his long-standing shoulder and finger pain. It was a clear reminder that a patient's occupational
background significantly influences their health issues and potential treatments wherein he when he was
working as a construction worker 3 year PTC, he had an eposide where he heard a pop in his biceps
which is consistent with a biceps tendon tear. This case prompted me to reflect deeply on the
importance of detailed history-taking, as overlooking even minor details could lead to misdiagnosis or
inadequate management.

Introspection during our discussion revealed gaps in my approach, particularly in considering the
patient's personal narrative and occupational history. Reynaldo's extensive construction work and
military background were critical factors that shaped his current health status. This realization urged me
to think beyond textbook symptoms and diagnoses, emphasizing a more holistic approach to patient
care.

A key insight from our discussion was the significance of empathy and active listening. Reynaldo's use of
descriptive terms like “Kirot” and “Kuryente” to express his pain was a powerful reminder of the need to
understand patients' perspectives and descriptions of their symptoms, which are often rooted in their
cultural or personal contexts.

Our group discussion made me critically evaluate my biases, especially regarding age-related
assumptions. Initially, I leaned towards attributing his symptoms to common age-related conditions
without considering his unique occupational risks and physical demands.

I learned valuable techniques for patient history and physical examination, such as the importance of
detailed occupational history and specific tests like the Yergason’s and Speed’s tests for shoulder
assessment. These strategies are vital for a holistic approach to patient care.

Reflecting on our discussion, I realized effective communication isn’t just about asking the right
questions; it’s about building rapport that encourages patients to share crucial information, sometimes
beyond what they initially present.

Mr. Olaes' reluctance to consider surgery, possibly due to fear or misunderstanding, taught me the
importance of delicately approaching sensitive topics. It’s vital to provide clear, empathetic explanations
to help patients make informed decisions.

This case study inspired me to delve deeper into understanding the complexities of musculoskeletal
disorders related to specific occupations. I plan to explore more resources and case studies to enhance
my skills in history taking and physical examination, particularly in rehabilitation medicine.

In conclusion, the small group discussion was an enlightening experience, underscoring the multifaceted
nature of patient care, where empathy, active listening, and a comprehensive approach to patient
history are as vital as clinical knowledge in achieving effective patient care and treatment outcomes.
Reflecting on our recent preceptorials in Rehab Medicine, particularly the case of RO a 59-year-old
construction worker, has been immensely insightful. It underscored the critical impact of accurate
patient history on treatment outcomes. This specific case, where a previous doctor recommended
arthroplasty, highlighted the need for careful evaluation before deciding on invasive procedures. The
group discussion encouraged me to introspect on my approach to patient history and assessments,
helping me identify potential gaps in my understanding of musculoskeletal issues, especially in the
context of work-related wear and tear.

Our discussion emphasized the importance of actively listening and empathizing with patients.
The patient’s detailed history of bilateral shoulder pain, previous surgeries, and ongoing struggles
provided a vivid picture of his condition. This reinforced the need to consider the patient's entire
narrative, not just the clinical symptoms but their personal and occupational background as well.

Critically, the session prompted me to evaluate my own biases or assumptions that might arise during
patient history taking. For instance, the assumption that surgery is the default solution for chronic pain
was challenged. The group's consensus on prioritizing pain management and rehabilitation over
immediate surgical intervention demonstrated a more patient-centric approach.

I discovered valuable strategies for conducting a comprehensive patient history and physical
examination. The case encouraged the use of ultrasound over X-rays for more detailed visualization of
musculoskeletal conditions. It also highlighted non-pharmacologic interventions like physical therapy and
ergonomic adaptations, which are often overlooked but vital in managing chronic conditions.

Reflecting on the discussion enhanced my understanding of the importance of effective communication

and rapport-building. The patient’s trust in the group's recommendation over a previous surgical
suggestion showcased the power of patient-doctor rapport.

Lastly, the case of RO, with his complex medical history and the initial recommendation for surgery,
drove home the importance of personalized care. It prompted me to seek further learning resources on
musculoskeletal disorders and their management, emphasizing a holistic approach over a one-size-fits-all
solution. This case has been a critical learning experience, underscoring the importance of reasoned
thinking and patient-tailored diagnostics and treatment in medical practice.