This consultation occurred during a fully booked morning surgery post triage and was set in my own room. I was not running late so was relaxed and not stressed or rushed at the time. The patient had pre booked a routine appointment the week before and wanted to discuss a lump he had found on the left side of his neck. He was a 26 year old male, previously fit and healthy and worked on a construction site. The total consultation lasted approximately 14 minutes.
During the introduction (44s) of the consultation I led the patient into the room, politely asked to take a seat and introduced myself with a handshake. There are various models which emphasise the importance of a good introduction. Certainly the Calgary-Cambridge model clearly has …show more content…
This I felt to be a good opening question as it brought out and focussed on the patient’s agenda while at the same time checking to see if there were any other issues, helping to prioritize early on during the consultation. McWhinney’s model makes mention in getting the clinician to see through the patients eye and he can do this in many ways so that the patient can be more open (McWhinney et al, 1986). After this opening question I observed the golden minute that is now discussed widely during GP training. Although consultation models do not refer directly to a “golden minute” they do encompass it particularly McWhinney’s model where it states “the key to the patient-centred method, as its name implies, is to allow as much as possible to flow from the patient. The crucial skill is to be receptive to cues offered by the patient” (McWhinney et al, 1986). The second aspect of this quote from this model refers to being able to pick up on cues, and in this instance this was done by me picking up the antibiotic bottle, looking at it therefore acknowledging what the patient had said and done. Allowing for the golden minute I was able to without much work bring about the patients agenda regarding his neck lump and also his ideas and …show more content…
I like having some organisation to my consultations and I tend to do this by following the Calgary-Cambridge model which highlights the need to provide structure by “summarising, signposting, sequencing, timing” (Silvermann et al, 1996). This element of the consultation provided me with enough information to move onto an examination without feeling I had missed anything. My agenda lasted 3 minutes and I felt that it may have made the patient feel uncomfortable so I made sure as per McWhinney’s model that I continued to weave in and out of both agendas by signposting again (3.25 minutes) that I would come back onto his lump, this insured that the patient did not feel his agenda was being taken over by my
During the introduction (44s) of the consultation I led the patient into the room, politely asked to take a seat and introduced myself with a handshake. There are various models which emphasise the importance of a good introduction. Certainly the Calgary-Cambridge model clearly has …show more content…
This I felt to be a good opening question as it brought out and focussed on the patient’s agenda while at the same time checking to see if there were any other issues, helping to prioritize early on during the consultation. McWhinney’s model makes mention in getting the clinician to see through the patients eye and he can do this in many ways so that the patient can be more open (McWhinney et al, 1986). After this opening question I observed the golden minute that is now discussed widely during GP training. Although consultation models do not refer directly to a “golden minute” they do encompass it particularly McWhinney’s model where it states “the key to the patient-centred method, as its name implies, is to allow as much as possible to flow from the patient. The crucial skill is to be receptive to cues offered by the patient” (McWhinney et al, 1986). The second aspect of this quote from this model refers to being able to pick up on cues, and in this instance this was done by me picking up the antibiotic bottle, looking at it therefore acknowledging what the patient had said and done. Allowing for the golden minute I was able to without much work bring about the patients agenda regarding his neck lump and also his ideas and …show more content…
I like having some organisation to my consultations and I tend to do this by following the Calgary-Cambridge model which highlights the need to provide structure by “summarising, signposting, sequencing, timing” (Silvermann et al, 1996). This element of the consultation provided me with enough information to move onto an examination without feeling I had missed anything. My agenda lasted 3 minutes and I felt that it may have made the patient feel uncomfortable so I made sure as per McWhinney’s model that I continued to weave in and out of both agendas by signposting again (3.25 minutes) that I would come back onto his lump, this insured that the patient did not feel his agenda was being taken over by my