Sunday, May 3, 2015

Agenda setting and negotiation with the patient. This is not helpful for the exam but will be helpful in your everyday work.

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One of the most important skills in General Practice is clear agenda setting at the beginning of the consultation.

Ask, "How can I help you today?"
Then ask, "Is there something else?"
Then ask, "Is there something else?" until there is nothing else.

Apparently a study have found that "Is there something else?" is more effective than "Is there anything else?".  However, I cannot locate this study.  Personally, both are effective although "something else" might be slightly more effective.  When you ask "Is there anything else?", patients tend to reply "no" more often possibly.

After you have outlined all the agendas, this will give you and the patient the opportunity to negotiate what can be addressed today.  For example, you can say…..

"Thanks for that.  I can see that you have a number of concerns.  As we have only a short appointment today, which one of these issues is most important to you.  We can sort this out properly today and as for the other issues, we can book in a long appointment next week.  This will allow us the appropriate time to address all of your concerns.  How does that sound to you?"

Share with us your tips and what works for you.

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