Achieving a patient-centred consultation by giving feedback in its early phases
Tony Haka, Peter Campionb
a Department of
Primary Care, University of Liverpool, Liverpool L69 3GB, UK, b School of Medicine, University of Hull, East
Riding Campus, Hull HU10 6NS, UK
Correspondence to: Dr Hak, Department of Primary Care, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, UK
Accepted 9 February
1999
The traditional medical consultation comprises history,
examination, and investigations, followed by explanation to the patient of diagnosis and management. In the course of studying a series of
tape-recorded consultations in a specialist medical clinic for chronic
fatigue, we have observed a different structure. In some consultations,
those categorised as more `patient-centred', doctors introduced
explanation and education into the early history-taking stage. This
strategy is contrasted with the traditional approach, where the doctor
only elicits information during the history, and gives an explanation
later. The `early feedback' strategy may result in patients with
chronic illnesses achieving greater understanding of their symptoms. We
discuss the implication of these findings for medical training.
Keywords: consultation; history-taking; training; communication
© 1999 by The Fellowship of Postgraduate Medicine
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