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?

  • Communication skills are a core clinical skill (WHO; GMC).

  • Diagnoses are made more frequently from interview data than all other sources combined.

  • Doctors conduct up to 200,000 interviews over a 40-year career (5,000/year).

  • 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.

  • 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.

  • 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).