The Aims
By the end of this session, the student will be able to:
- Know the definition of the consultation.
- Know the different types of consultation.
- Appreciate the importance of effective consultation.
- Understand the utilization of each type.
- Recognize the barriers of effective consultation.
- Recognize the essential skills for effective consultation.
- Modify the consultation in special situations.
What is the Consultation?
- It is the central act of medicine.
Why Do We Talk About the Consultation?
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Communication skills are a core clinical skill (WHO; GMC).
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Diagnoses are made more frequently from interview data than all other sources combined.
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Doctors conduct up to 200,000 interviews over a 40-year career (5,000/year).
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Doctors identify their patients’ problems more accurately.
Maguire et al. BMJ 1986; 292: 1573-1578. -
Patients are more satisfied with their care and can better understand their problems, investigations, and treatment options with fewer complaints.
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Patients are more likely to adhere to treatment and follow advice on behavior change.
Silverman, Kurtz, Draper. Skills for communicating with patients. Radcliffe Medical Press, 1998. -
Patients’ distress and their vulnerability to anxiety and depression are lessened.
Roter et al. Arch Intern Med 1995; 155: 1877-1884. -
Doctor is more time-efficient.
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Doctors’ own wellbeing is improved.
Ramirez et al. Lancet 1995; 16: 724-728.
Check Point
“It is more important to know what sort of person has a disease than to know what sort of disease a person has.”
Hippocrates (circa 400 BC).