Discussion

The first three points should be attended to clearly right at the start of the management phase, to avoid any conflict or misunderstanding between doctor and patient. The doctor can then commence education about the diagnosis, correcting any incorrect health beliefs recognised in point 2, and supplement the patient's existing knowledge to a level appropriate to the needs of the patient and doctor.

The management plan for the presenting problem must be clear and specific—if complicated, the steps involved should be written down for the patient to take home. Immediate management should always be included even if no action is proposed. Long-term management strategies are useful for chronic or recurrent illness to help the patient envisage what the future holds. Preventive measures may be a specific part of the long-term management or just require patient education. The patient encouraged to participate in decision making should indicate commitment to the plans, which reinforces the essential information and encourages the patient to accept some degree of responsibility for the management of his or her own illness.

The final, yet essential, step in the management consultation is precise follow-up. Follow-up strengthens an ongoing doctor-patient relationship where the doctor indicates genuine concern and interest in that patient's long-term health needs.

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