dr. abdullah alshahrani (mbbs/cabfm/ post graduate trainer)
DESCRIPTION
CONSULTATION MODELS. DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER) Joint Program of Family Medicine, Aseer. Objectives. What is the consultation What are the benefits of consultation What are the types of consultation - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/1.jpg)
DR. ABDULLAH ALSHAHRANI(MBBS/CABFM/ POST GRADUATE TRAINER)
Joint Program of Family Medicine, Aseer
CONSULTATION MODELS
![Page 2: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/2.jpg)
What is the consultation
What are the benefits of consultation
What are the types of consultation
How to change from traditional biological model to a more
comprehensive model
Objectives
![Page 3: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/3.jpg)
Consultation Definition:
The essential unit of medical practice is the occasion when in the intimacy of the consultation room, the person who is ill or believes himself to be ill, seeks the advice of a doctor who he trust.
( Sir James Spence 1949 )
IntroductionIntroduction
![Page 4: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/4.jpg)
Consultation Models
• Hospital Model( Biological Model):Hospital Model( Biological Model):
• PHC Model( Bio-psycho-social Model).PHC Model( Bio-psycho-social Model).
• Stott &Davis (The Expanded Model)Stott &Davis (The Expanded Model)
• Pendleton Model( 7 Tasks).Pendleton Model( 7 Tasks).
• Neighbour Model( Anticipatory care) (difficult Neighbour Model( Anticipatory care) (difficult consultation).consultation).
![Page 5: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/5.jpg)
Sara is 38 years old lady, complaining of 2 weeks history of headache.
How are you going to conduct this consultation
![Page 6: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/6.jpg)
HISTORY PRESENTING COMPLAIN
SYSTEMATIC REVIEW
EXAMINATION
INVESTIGATION
DIAGNOSIS
TREATMENT
FOLLOW-UP
A case of 2 weeks headache
Computerized Checklist of history
Taking.
Hospital Model of Consultation (Bio – Medical Model)
![Page 7: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/7.jpg)
Characteristics of Hospital Model
It is doctor centered and disease oriented.
A diagnosis must be arrived at "objectively" before treatment.
It takes long time
No consideration of the psychosocial dimensions explanation, health education, health promotion and treatment by reassurance
![Page 8: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/8.jpg)
PHC Model of Consultation(Bio-psychological Model)
![Page 9: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/9.jpg)
Sara is 38 years old lady, divorced 2 weeks ago, looking after 5 children by herself, complaining of 2 weeks history of headache
Speculate how Sara think about her illness? Her ideas??? Her concern??? Her fears??? The effect of the problem in her life???
What is most likely the diagnosis???
![Page 10: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/10.jpg)
Characteristics of PHC Consultation Model
Patient – centered
Holistic approach (Bio-psycho – social)
Prevention & Health education
Treatment by reassurance
Appropriate use of time & resources
![Page 11: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/11.jpg)
Management of Modification of Help Presenting Problem Seeking Behaviour
Management of Opportunistic healthContinuous Problem Promotion
The Expanded Model of Consultation(Stott & Davis 1979)
![Page 12: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/12.jpg)
To define the real reasons for pt attendance
To consider other problems
To choose with the pt. appropriate action for each problem
To achieve a share understanding
To involve pt. in the management
To use time & resources effectively
To establish & maintain Dr – pt relationship
Pendleton Model
![Page 13: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/13.jpg)
Pendleton First Task
• History• Nature of the problem• Causes• Effect of the problem
To Explore the real reasons for pt. Attendance
![Page 14: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/14.jpg)
Patient’s Ideas:
Neurological problem.
Becoming disable or crazy.
Cannot work as a teacher anymore
?
![Page 15: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/15.jpg)
Patient’s Concern:
Financial insecurity
![Page 16: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/16.jpg)
Sick leave
Investigation
Treatment
explanation
Patient’s Expectation:
![Page 17: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/17.jpg)
Pendleton Second Task
To consider other problems
![Page 18: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/18.jpg)
Pendleton Third Task
With the patient to choose an appropriate action for each problem
Why?
Patient responsibilityPatient compliance
![Page 19: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/19.jpg)
Pendleton Fourth Task
With the patient to reach Shared Understanding of the ProblemDoctor Patient
KnowledgeQuestions
DoubtsTheories
Experience
KnowledgeQuestions
DoubtsTheories
Experience
![Page 20: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/20.jpg)
Pendleton Fifth Task
To involve patient in the management
![Page 21: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/21.jpg)
Pendleton Sixth Task
To use Time and Resources appropriately
![Page 22: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/22.jpg)
Pendleton Seventh Task
To Establish & MaintainDoctor – Patient Relationship
![Page 23: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/23.jpg)
• Connecting (establishing relationship)
• Summarizing (physical, social & psychosocial diagnosis)
• Handing-over (management of presenting symptom)
• Safety netting (Red flags)
• House-keeping (Taking care or yourself)
Neighbor ModelThe Inner Consultation
![Page 24: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/24.jpg)
Approach to Sara Problem
Safety-netting:
Is there any possibility of serious differential diagnoses or complications from her headache?
![Page 25: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/25.jpg)
Approach to Sara Problem
House Keeping
This consultation may result in some negative feelings, examples:
Sad feeling because of Sara's divorce. Helpless feeling because of her financial problem.
![Page 26: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/26.jpg)
Approach to Sara Problem
House Keeping
Sad feeling for her children. Feeling of being under pressure of time, because of this long
consultation. Feeling anxious about the reaction of the next patient for being
waiting for so long.
How to deal with these feelings?
![Page 27: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/27.jpg)
Hospital Model of Consultation is not suitable for Family Medicine
Family Medicine Model of Consultation is characterized by:
Holistic ApproachDeep understanding of human behaviour
Conclusion
![Page 28: DR. ABDULLAH ALSHAHRANI (MBBS/CABFM/ POST GRADUATE TRAINER)](https://reader034.vdocuments.net/reader034/viewer/2022042609/56813e3a550346895da81e4c/html5/thumbnails/28.jpg)
Home Messages
A lot of practice is needed to be able to adopt the proper consultation model
Consultation is a communication with a human being with feelings & thoughts…it is not just clinical skills