Transcript Consultation Models : Neighbour

Consultation Models:
Neighbour
Helen Locking
VTS
January 2005
Consultation Models
• Roger Neighbour – who is he?
• What did he do?
• Why do we need to know about him?
• What is it?
• Case Study
Roger Neighbour
GP
Principal & Trainer in Hertfordshire until
2003
Course Organiser of Watford VTS
Inaugural Fellow of Assoc of Course
Organisers
MRCGP Examiner
President of RCGP 2003
What did he do?
“The Inner Consultation” - 1987
“The Inner Apprentice” - 1992
Why do we need to know?
MRCGP Exam
Easy Model to adopt & adapt.
Encompasses both Patient and Dr
wellbeing
Neighbour’s Consultation Model
4. Safety
netting
5. House
keeping
3. Handing Over
2. Summarising
1. Connecting
1. Connecting
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Rapport
Gambits & Curtain Raisers
Minimal cues
What is said & not said
Eye movements
3 cardinal mental thought processes
Speech censoring
Internal Speech
Acceptance Set
2. Summarising
•What information do we need?
I, C, E.
Feelings
Effects of symptoms, treatment etc
•When should you elicit that information?
•What signals can the patient give to suggest that
more information could be elicited?
•How should we elicit the information?
3.Handing Over
•Negotiating
Give the patient options
•Influencing
in my opinion…
Use questions instead of statements
Reframing
Shepherding
Pre-empting
My friend John…
•Gift Wrapping
Chunk & Check
How to give instructions – rule of 3.
4. Safety Netting
•“General Practice is the Art of Managing Uncertainty”
•If I am right, what do I expect to happen?
Worst case scenario
Instructions to patient
F/U - What if patient doesn’t come back?
•How will I know if I am wrong?
•What will I do then?
What to say to the patient
5. House Keeping
•Long term
•In between Patients
•During Consultations
Neighbour’s Consultation Model
4. Safety
netting
5. House
keeping
3. Handing Over
2. Summarising
1. Connecting