Recipe for disaster

(hypothetical medical exam)

- height (use of an instrument that automatically subtracts .4 inches)

- weight (have patient remove necklace but not 5, possibly 15 lb, watch)

- blood pressure (after completion of above - tell patient to think "happy thoughts"; upon (not so great) results, retake in 5 min.; after (not so great) results, tell patient that bp is a little high and should retake later in the week)

- shots (tell patient about two options for immunization - pill or shot; after dangling pill offer, tell patient that it will not work with travel date; then ask patient if s/he has had bp taken again even though only a few hours have passed since last visit; (ir)regardless of answer, give shot)