What to Expect During Your First Consultation

Before Your Appointment: What Happens First

Once your consultation is booked, you will receive a confirmation with the time, location (for in-person appointments), or a secure video link (for online appointments). You may also be asked to upload:

• Recent blood test results

• Hospital letters

• Scan or ECG reports

• A short description of your symptoms

• Your current medication list

  
  

You do not need to prepare a long story. A brief summary is enough — we explore the details together during the appointment. If you do not have any documents, that’s fine. Many patients come with nothing except their symptoms and their concerns.

Step 1: A Detailed Conversation About Your Symptoms

The consultation begins with a clear, structured conversation. My job is to understand:

• What your symptoms are

• When they started

• What makes them better or worse

• How they have changed over time

• What you are most worried about

• What has already been investigated

  
  

This is not a rapid questionnaire — it is the core of the appointment. Most diagnoses in internal medicine come from understanding the story properly. Patients often say: “This is the first time someone has connected all the pieces.” That is the goal.

Step 2: Reviewing Any Previous Results

If you have had tests before — bloods, scans, ECGs, or hospital assessments — I will go through them with you. This is often the moment where confusion turns into clarity. Many people have results they do not fully understand:

• “My GP said my thyroid is a bit off, but what does that mean?”

• “The hospital mentioned inflammation, but no one explained why.”

• “I had a CT scan — is it normal or not?”

  
  

We review everything in plain English, focusing on what is relevant and what is not.

Step 3: Physical Examination (In-Person Appointments)

If you are seen in person at Salford, I will perform a targeted physical examination. This may include:

• Heart and lung examination

• Blood pressure check

• Pulse rhythm assessment

• Abdominal examination

• Oxygen saturation

• Temperature

  
  

The purpose is not to “tick boxes,” but to look for signs that support or contradict possible explanations for your symptoms. For online consultations, this part is naturally not possible, but many conditions can be assessed safely without a physical exam. When I feel an in-person review is needed, I say so clearly.

Step 4: Explaining What Is Most Likely Going On

Once we have gathered the information, I explain what the symptoms are most likely related to. This includes:

• The probable cause

• Conditions that seem unlikely

• Conditions that must not be missed

• Whether the situation is urgent or routine

• What needs investigating

• What does not need investigating

  
  

The aim is not to alarm you, nor to offer false reassurance — but to give you a realistic, senior medical opinion. Patients often tell me, “I feel calmer now. I finally understand what is happening.”

Step 5: Deciding What Tests (If Any) Are Needed

Not every consultation leads to tests. In fact, many problems can be understood without them. But when investigations are appropriate, we discuss:

• Which tests make sense

• Why each test is useful

• What information it will give

• What it cannot rule out

• Whether it needs to be done urgently or routinely

  
  

Depending on the situation, you may be able to book:

• Blood tests

• ECG

• Holter monitoring

• Chest X-ray

• Metabolic or thyroid profiles

  
  

Tests are used to answer precise questions — not because they are available.

Step 6: Your Personalised Plan

At the end of the consultation, we summarise everything into a clear plan. Typically, this includes:

• What we think is happening

• What needs to happen next

• What signs to monitor

• When to seek urgent help (if relevant)

• When to follow up

• Whether to involve your GP

• Whether further assessment is needed

  
  

A plan should not be vague. You should leave the consultation knowing exactly what to do.

Step 7: The Letter for Your GP — How It Works

After the appointment, I write a structured medical summary. This includes:

• Your main symptoms

• Key points from your history

• Important findings from the examination (if in person)

• Interpretation of any previous tests

• The working diagnosis

• The plan we agreed on

• Any recommended investigations

• Safety-netting advice

  
  

You receive this letter. You can also share it with your GP, and many patients choose to do so. This ensures continuity of care — something essential in internal medicine.

Online vs In-Person: What’s the Difference?

Online consultations are ideal for:

• Reviewing persistent symptoms

• Going through results

• Getting a second opinion

• Planning investigations

• Clarifying your next steps

  
  

In-person consultations are better for:

• New chest discomfort

• Breathlessness

• Abdominal pain

• New heart murmurs

• Complex multisystem problems

  
  

Both formats follow the same structure. Both provide a senior-level assessment. The only difference is the examination.

After Your Consultation: What Happens Next

Depending on your situation, the next steps may include:

• Booking recommended tests

• Updating your GP

• Adjusting medications (via your GP when appropriate)

• Arranging a follow-up consultation

• Monitoring symptoms with clear guidance

  
  

You are never left unsure of what to do next.

In Summary

A first consultation with me is designed to be clear, structured, and practical. You should leave with:

• A coherent explanation of what is happening

• A plan that makes sense

• Safety-netting advice

• A summary letter you can keep or share

• Confidence that your concerns have been heard and understood

  
  

Medicine should not feel rushed or confusing. It should feel like a conversation — one that leads to clarity, not more uncertainty.

I consult in person in Salford (Eric Healthcare, Bowsall House, 3 King Street, Salford M3 7DG) and online across the UK.

Telephone: 0121 838 1869

DrParaiso.co.uk