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Consultation Models

Consultation Models. The doctor who specialises in the patient Physical, psychological and social care Continuing care of on-going conditions Early diagnosis and initial treatment Treatment of chronic/terminal conditions Health promotion Care of patients, families and communities.

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Consultation Models

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  1. Consultation Models

  2. The doctor who specialises in the patient • Physical, psychological and social care • Continuing care of on-going conditions • Early diagnosis and initial treatment • Treatment of chronic/terminal conditions • Health promotion • Care of patients, families and communities What is a GP?

  3. Rapport • Discover the patients problem – agenda • Understand the patients beliefs • Make a diagnosis/form opinion • Explain to the patient the management plan • Plan for eventualities/follow up • All this in 10 minutes! Aims of the Consultation

  4. Many models • Structure of consultation • Psychology of the consultation • How to achieve the maximum in a consultation • The differences between a hospital and GP consultation Consultation Models

  5. The Doctor, his patient and his illness (1957) • Psychoanalyst • Several themes • The apostolic function • The drug doctor • The collusion of anonymity • The mutual investment fund • The flash Balint

  6. The exceptional potential in each consultation • Managing the presenting complaint • Managing the on-going problem • Opportunistic health promotion • Modifying health seeking behaviour Stott and Davis (1979)

  7. The questions patients have when see a doctor • What has happened? • Why has it happened? • Why to me? • Why now? • What would happen if nothing were done about it? • What should I do about it? Helmans Folk Model1981

  8. Connecting • Rapport • Summarising • Showing you understand the patient • Handover • Offering a management solution to the patient • Safety-netting • Planning for eventualities • Housekeeping • Making sure you are ready to see the next patient Neighbour 1987

  9. 1. Define the problem (ICE) • 2. Consider other options • 3. Choose appropriate action • 4. Share understanding with the patient • 5. Involve patient in management decisions • 6. Use time and resources well • 7. Establish and maintain the dr-patient relationship Pendleton 1994,2003

  10. 1. Initiating the session • 2. Gathering information • 3. Building the relationship • 4. Explanation and planning • 5. Closing the session Calgary – Cambridge

  11. The Golden Minute

  12. The Inner Consultation – Roger Neighbour • The New Consultation: developing doctor-patient communication. Pendleton, Schofield, Tate and Havelock • The Doctor’s Communication Handbook. Tate P Resources

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