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Dr Amir Khan shares 'end-of-the-bed' test GPs do on every patient

Dr Amir Khan said it was common practice among GPs

[Dr Amir Khan said he examines people as soon as they enter his office]

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Dr Amir Khan said he examines people as soon as they enter his office(Image: Lorraine)

Dr Amir Khan has explained a test he and other GPs do across the country on every patient they see. The well-known TV doctor said it begins the moment you walk into his office.

Dr Khan said that, rather than waiting for the patient to start explaining their symptoms, he starts 'observing' them from the moment they 'walk through the door'.

And he is not the only one to do it. Many GPs reportedly take this approach - it is apparently known as the 'end-of-the-bed assessment'. Dr Khan said that, while it did not replace clinical tests, it often gave the first clue as to what the problem was.

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He explained: "As a GP, I've actually started examining you before you've even sat down in my room. Not deliberately, it's just something we learn to do. The first thing I might notice is how a patient walks into the room. Are they walking normally? Are they limping? Are they shuffling? Are they holding on to furniture? How quickly can they move from the waiting room down the corridor into my room? That can give me clues about pain, muscle strength, balance and neurological problems.

"Then I always notice how they sit down or try and get back up again. If you need your arms to push yourself out of a chair, particularly if that's new, that can point sometimes towards reduced muscle strength, and occasionally things like a joint or neurological problem.

"Then I check their breathing while they're talking to me. I am listening to them talk, but I'm also noticing whether they can finish a sentence without stopping for breath. Are they breathing unusually quick? Are they using extra muscles around their neck or shoulders to breathe? Or are they sitting comfortably and just chatting comfortably? Because someone can tell me, "My breathing isn't too bad," but their body is telling me something very different.

"Then I look at their face and their skin. Do they look unusually pale, flushed, sweaty, yellow? Are their lips a normal colour? Again, none of these things give me a diagnosis by themselves, but they are clues alongside what they might be telling me.

"And probably one of the most important things I notice is how they compare with their normal self. Sometimes a relative will say, "Well, he's just not himself." And that sentence can be incredibly important, particularly in older people. A change in alertness, speech, behaviour, or confusion can sometimes be one of the first signs that someone is unwell."

What does the NHS

The NHS website says that it is often a good idea to prepare several things in advance. This includes:

• Making a note of things you want to discuss
• Mentioning any medicines that you use
• Prepare any questions you wish to ask
• Be prepared to talk to the healthcare professional until you understand the situation
• Ask someone to come with you if it makes you feel more comfortable

The NHS urges people not to be afraid about asking for clarification if you do not understand something - including medical terminology. It also says you should check your list to make sure you have covered everything before leaving, and remember to book any appiontments you need as soon as possible.

Ask:

• Who to contact if you have any more problems or questions.
• About support groups and where to go for reliable information.
• For copies of letters written about you you're entitled to see these.

[Dr Amir Khan on ITV]

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The NHS GP is well-known for his presence on social media(Image: ITV)

'Observation never replaces listening to the patient'

"When you come into my consulting room, yes, I'm listening to your symptoms, but I'm also watching how you walked in, how you're breathing, how you're moving, how you're interacting with me, because some of those things are just as important as what you're telling me or any test that I can order," Dr Khan concluded. "Because the body's started telling me the story before the patient even starts talking to me.

"Doctors sometimes call it the 'end-of-the-bed' assessment those little clues you gather before youve even picked up a stethoscope or asked the first proper question.

"Of course, observation never replaces listening to the patient, examining them or doing the appropriate tests. But sometimes the first clue to whats going on arrives before the first word does."

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