Begin a discussion on why a patient’s vital signs might differ at various times during the day. (Stress, excitement, illness, and environmental factors may all affect blood pressure.) Most physicians’ offices have the medical assistant take and record the patient’s vital signs and measurements before the physician sees the patient. Ask: Why do you think this is? (It saves the physician time. In addition, patients may be less nervous with the medical assistant than they would be with the physician, because of white-coat syndrome. If any result, other than the temperature is elevated, by the time the physician sees the patient the falsely high reading may also have dropped, because patients tend to become more at ease with time.)