*Consultation Models

*What is a GP?

*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

*Aims of the Consultation

*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!

*Consultation Models

*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

*Balint

*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

*Stott and Davis (1979)

*The exceptional potential in each consultation

*Managing the presenting complaint

*Managing the on-going problem

*Opportunistic health promotion

*Modifying health seeking behaviour

*Helmans Folk Model1981

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?

*Neighbour 1987

*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

*Pendleton 1994,2003

*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

*Calgary – Cambridge

*1. Initiating the session

*2. Gathering information

*3. Building the relationship

*4. Explanation and planning

*5. Closing the session

*The Golden Minute

*Resources

*The Inner Consultation – Roger Neighbour

*The New Consultation: developing doctor-patient communication. Pendleton, Schofield, Tate and Havelock

*The Doctor’s Communication Handbook. Tate P