Consultation styles

Jasleen Boparai
54
 Consultation Models
"Bad consultations result from having insufficient
clinical knowledge, from failing to relate to patients
or from failing to understand the patient's
behaviour, his perception of his illness or its
context"
 Byrne & Long (1976)
6 Phases of the Consultation
1. The doctor establishes a relationship with the patient

2. The doctor discovers or attempts to discover the reason for

the attendance

3. The doctor conducts a verbal and/or physical examination

4. The doctor, the doctor and patient, or the patient (in that

order of probability) consider the condition

5. The doctor and occasionally the patient detail further

treatment or investigation

6. The consultation is terminated, usually by the doctor

Consultation styles

● Doctor centered
● Patient centered
In the doctor-centred consulting style, the doctor:
● dominates the consultation
● asks direct, closed questions
● rejects the patient's ideas
● evades the patient's questions
● diseases and patient are completely separate
● tightly controlled
● doctors take the dominant role
● patients have limited participation
● patients not expected to participate actively
● patients' health is in entirely in the hands of the doctor
● doctors ask leading questions
● impact of disease on patients' life is barely considered
In the patient-centred consulting style, the doctor:
● asks open questions
● actively listens
● challenges and reflects the patients' words and
● behaviour to allow them to express themselves in
their own way
 One of the problems in implementing patient
centredness in practice is knowing which
elements are the most important. One influential
patient centred model of consultation with a
doctor encompasses five principal domains:
Main domains of model of patient centredness
• Exploring the experience of disease and
illness: patients' ideas about the
problem, feelings, expectations for the
visit, and effects on function
 • Understanding the whole person:
personal and developmental issues (for
example, feeling emotionally
understood) and the context (the family
and how life has been affected)
• Finding common ground (partnership):
problems, priorities, goals of treatment,
and roles of doctor and patient
•Health promotion: health enhancement,
risk reduction, early detection of
disease
• Enhancing the doctor-patient
relationship: sharing power, the caring
and healing relationship
THANK YOU