A continence appointment and embarrassment

Setting: A community continence clinic

An adult has attended reluctantly after a referral. The first appointment is a private discussion of the patient's experience and goals; any later examination would be separately explained and consented to.

Task

Explore the concern behind the opening: "I do not want an examination. I nearly did not come at all."
Clarify the specific barrier and acknowledge its effect on the patient.
Explain the supplied next steps and respond to this possible question: "Can I talk about the problem without agreeing to an examination today?"
Check the patient can distinguish what is agreed from what needs confirmation.

A continence appointment and embarrassment supplied plan

An adult has attended reluctantly after a referral. The first appointment is a private discussion of the patient's experience and goals; any later examination would be separately explained and consented to.
Today's planned first step is a private conversation about symptoms, their effect on daily life and what the patient wants help with.
Any proposed examination is explained separately, including the patient's questions and agreement; attendance is not blanket consent.
Do not promise a diagnosis, treatment outcome or that no examination will ever be recommended.
We can start by talking privately about what has been happening and how it affects your day. Your first-visit plan also offers a diary of drink times and toilet visits to discuss at review, if you want that explained.
Any examination would be a separate proposal, with an explanation and a chance for you to decide. Coming to the appointment does not mean you have already agreed to an examination.

Fictional exam scenario only. Supplied arrangements are not medical guidance for a real patient..