A Highland GP on life the universe and anything…

When I am chatting to friends and family about times they have seen a GP I am often sad to hear that they have not necessarily had a happy experience. I wonder if I would have done any better but it also occurred to me that there might be things patients could do to increase their satisfaction too.

Many consulting theories are used to help GPs improve the outcomes of the consultation and it occurred to me that some might be equally valid if rewritten as a guide for patients. I chose Pendleton et al “7 Tasks” model .

How to make best use of 10 minutes with your GP

1. Think about the reason for coming today
a. List your symptoms and write a brief time-line of what has happened.
b. Does anything make it better or worse?
c. What have you already tried?
d. What thoughts do you have? Causes, concerns, need for tests or treatment
e. What effect is it having on your life?
f. Have you had anything similar before?
2. Do you have other ongoing health problems to discuss or do you want help with keeping healthy?
3. Don’t be scared to discuss your own preferences.
Do you have a preference for medicines, talking treatment or lifestyle changes.
4. Make sure you understand your doctor’s idea about the diagnosis, plans for treatment and follow-up
5. Be clear about what is expected of you and what else you can do to stay healthy or get better more quickly
6. If you have more than one problem say so early so you and your doctor can use the appointment time efficiently
7. Your long term relationship with you doctor and surgery is important. Social chat helps you get to know each other but should not get in the way of getting the help you need.

A great deal of effort and work is spent improving the communication skills of the next generation of doctors and GPs and we continue to aspire to better collaborative working with our patients. Perhaps by sharing our ideas about the theories of consulting we can make real strides to true patient centred care.

Based on: –
Pendleton et al: The Consultation- An approach to learning and Teaching. 1984

It lists seven tasks that form an effective consultation. The model emphasises the importance of the patient’s view and understanding of the problem: –

1. To define the reasons for the patient’s attendance include
a. the nature and history of the problem
b. their cause
c. the patient’s ideas, concerns and expectations
d. the effects of the problem
2. To consider other problems:
e. continuing problems
f. risk factors
3. To choose with the patients an appropriate action form each problem
4. To achieve a shared understanding with the patient
5. To involve the patient in the management plan and encourage him to accept appropriate responsibility
6. To use time and resources appropriately
7. To establish or maintain a relationship with the patient which helps to achieve the other tasks

Pendleton D, Schofield T, Tate P, Havelock P. The consultation: an approach to learning and teaching. Oxford: Oxford University Press, 1984.

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