The Consultation, published almost 20 years ago by the same authors, has been completely rewritten. The New Consultation will be an essential aid for all doctors and their educators to increase the effectiveness of their consultations and to help to make them more patient-centred. It includes theoretical background as well as practical help for both consulters and teachers. The consultation is 'the central act of medicine': the meeting between the patient and the doctor. The first part of the book takes the reader from the context of the consultation in society and with the medical profession, to the intimacy of the consulting room, and then delves into its processes. The reader is invited to share the individual perspectives of doctor and patient and to consider what will lead to positive outcomes. The last chapter of the first section puts all these factors together and provides a coherent, evidence-based description of the processes needed for an effective consultation for the patient, the doctor, and society. The second part of the book takes the reader into the practicalities of learning and teaching effective consultations.
It starts with a brief description of the evidence for effective teaching and outlines the authors' experience of teaching in this way with over 1,000 doctors. Realizing that many doctors organize their own self-directed learning, the authors have included a chapter that enables individuals to develop their own consulting technique. Help is offered for teachers of the consultation in both undergraduate and postgraduate settings. The consultation is now assessed by a number of the royal medical colleges to measure competence and there is a chapter on these issues. The last chapter discusses the difficulties that many doctors still have in conducting patient-centred consultations and makes some suggestions for effective implementation of skills.
1. Introduction ; 2. The cycle of care ; 3. The context of the consultation ; 4. Understanding the patient ; 5. Understanding the doctor ; 6. Understanding the consultation ; 7. Learning and teaching about the consultation ; 8. Putting the tasks into practice ; 9. Teaching in educational settings ; 10. Describing and assessing consultations ; 11. Implementation of the approach to teaching and learning