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When doctors and patients talk: making sense of the consultation

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Published: July 2012
Author(s):

Martin Fischer, Gill Ereaut

This report explores the main form of interaction between a patient and a clinician – the consultation. It uncovers the anxieties that both parties may feel, with doctors and patients each having their own concerns.

The report offers a powerful analysis of the current relationship, identifying the mutual fears that drive doctors and patients and the invisible structures that are natural to the doctor but hidden from the patient. It also describes the potential for a more nuanced model for the consultation.

In order for patients to be better involved in making decisions about their own care, the consultation needs to change. Commissioning bodies and service providers need to develop programmes that will boost patient skills and confidence and also support those doctors who are keen to experiment with new ways of working.

The report looks at five main themes, or ways of thinking differently about the current patient–clinician relationship, which might lead to different thinking about how to act. These themes are:

  • making sense of ‘the consultation’
  • fear as a driver of the dynamic
  • invisible structures
  • fragmented conversations
  • system dynamics. 

We hope that this report will provide valuable insight and provoke fresh thinking.

Additional person-centred care resources

If you’re interested in person-centred care then take a look at our dedicated Person-centred care resource centre for hundreds of practical tools, materials and downloads.





 
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Comments
This publication didn't deliver what it promised in discussing so-called "system dynamics". The authors use this term as if in complete ignorance of the fact that there is an entire discipline bearing the name System Dynamics (SD). This discipline is full of nice people who would never come onto a site like this just to criticize someone's effort. I guess that is what makes me an amateur.

The whole of chapter 6 discussed all of 1 topic of relevance to SD, feedback. And it was not treated in a way that reflects a knowledge of SD. In fact, this chapter is a Complex Adaptive Systems (CAS) analysis bearing the name "system dynamics" as if the field of SD didn't even exist.

The Health Foundation didn't look so highly on CAS in its evidence scan published in 2010. So, why did they fund this project?

If I would have had this on my desk as a deliverable, I would have docked the authors' pay by 20%, asked them to drop the chapter, or change the content to reflect CAS methods and thinking.
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