The idea of a checklist of required or standard examination procedures is a foundation of my practice as well. I always like to discuss what will be expected and carried during their visit out with my patients before the actual appointment date. This gives them the pleasure of being able to anticipate events and prepare themselves properly for what is to come. I also like to request that a complete and detailed medical history form be answered in writing before we can begin. This can be sent through email, snail mail, or returned in person on the day of the exam.
When the appointment time arrives, we both review the medical history form in a businesslike way, and I make certain to clarify any questions about it that may have arisen. I also make certain to inquire whether there have been any changes or new concerns that have come up since the appointment was made, or if there is anything else the patient would like to discuss. Finally, I make it a point to encourage him to speak up during the actual examination/treatment session, because occasionally the exam itself will trigger a memory of a problem or a question that escaped his notice during our pre-session interview.
I keep detailed records of my findings on the checklist as we proceed through the exam -- and file these away for use during followup visits. It is always nice to be able to say to a repeat patient, "I notice in your records here that we neglected to do thus-and-so during your last visit, and I think we ought to take care of that today -- don't you?" Or to add, "I see in the chart that you reacted strongly to this or that test. I'd like to repeat it now, just to compare your responses."
Of course, the patient is always entitled to a copy of the records, for his review after the examination is completed, but I reserve the right to keep a copy in my own files for future reference. Successful doctor/patient relationships are a two way street, and depend on mutual respect, trust, honesty, and communication. I don't entrust such essential information to the vagaries of memory alone -- lest important details be lost in the shuffle. (I also make a checklist when I give a dinner party, so I don't forget a salad or a side dish in the oven or the refrigerator in the heat of the moment.) Thanks, BigK, for starting an important thread of conversation!