Models of the consultation

Several models that formalise the general practice consultation can be very useful for developing an understanding of the process of the consultation. Two classic models are those by Pendleton and his colleagues, and by Stott and Davis. Pendleton and colleagues in their landmark book The consultation: An approach to learning and teaching 1 defined seven key tasks to the consultation, which serve as helpful guidelines:

1. To define the reason for the patient's attendance, including:

o the nature and history of problems o their aetiology o the patient's ideas, concerns and expectations o the effect of the problems

2. To consider other issues:

o continuing problems o risk factors

3. To choose, with the patient, an appropriate action for each problem

4. To achieve a shared understanding of the problems with the patient

5. To involve the patient in the management and encourage him or her to accept appropriate responsibility

6. To use time and resources efficiently and appropriately:

o in the consultation o in the long term

7. To establish or maintain a relationship with the patient that helps to achieve the other tasks.

The exceptional potential in each primary care consultation described by Stott and Davis, 2 which is presented in Table 3.1 , also acts as an excellent aide-mémoire to achieve maximal benefit from the consultation.

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