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Consultation Models: Neighbour. Helen Locking VTS January 2005. Consultation Models. Roger Neighbour – who is he? What did he do? Why do we need to know about him? What is it? Case Study. Roger Neighbour. GP Principal & Trainer in Hertfordshire until 2003
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Consultation Models:Neighbour Helen Locking VTS January 2005
Consultation Models • Roger Neighbour – who is he? • What did he do? • Why do we need to know about him? • What is it? • Case Study
Roger Neighbour • GP • Principal & Trainer in Hertfordshire until 2003 • Course Organiser of Watford VTS • Inaugural Fellow of Assoc of Course Organisers • MRCGP Examiner • President of RCGP 2003
What did he do? • “The Inner Consultation” - 1987 • “The Inner Apprentice” - 1992
Why do we need to know? • MRCGP Exam • Easy Model to adopt & adapt. • Encompasses both Patient and Dr wellbeing
Neighbour’s Consultation Model 4. Safety netting 3. Handing Over 5. House keeping 2. Summarising 1. Connecting
1. Connecting • Rapport • Gambits & Curtain Raisers • Minimal cues • What is said & not said • Eye movements • 3 cardinal mental thought processes • Speech censoring • Internal Speech • Acceptance Set
2. Summarising • What information do we need? • I, C, E. • Feelings • Effects of symptoms, treatment etc • When should you elicit that information? • What signals can the patient give to suggest that • more information could be elicited? • How should we elicit the information?
3.Handing Over • Negotiating • Give the patient options • Influencing • in my opinion… • Use questions instead of statements • Reframing • Shepherding • Pre-empting • My friend John… • Gift Wrapping • Chunk & Check • How to give instructions – rule of 3.
4. Safety Netting • “General Practice is the Art of Managing Uncertainty” • If I am right, what do I expect to happen? • Worst case scenario • Instructions to patient • F/U - What if patient doesn’t come back? • How will I know if I am wrong? • What will I do then? • What to say to the patient
5. House Keeping • Long term • In between Patients • During Consultations
Neighbour’s Consultation Model 4. Safety netting 3. Handing Over 5. House keeping 2. Summarising 1. Connecting