The patient walks in carrying his own notes. The whole encounter is usually over in about 5 minutes but much is decided in this time. The surgeon books the patient directly on to his surgical list diary before writing a very brief summary into the patient notes which they carry with them to the junior resident on admission.
Patients present quite late in the natural history of their disease. They often consult their local traditional healer or witchdoctor before approaching conventional medicine as a last resort. Healed scars and tattoos are evidence of such consultations.