From Open Verse
Adapted from IDDT Newsletter March 2024
What can patients do to help ensure a good consultation with their GP or specialist doctor?
This was the aim of a diabetes support group. They brainstormed what they wanted to achieve and then discussed the way to get this.
The first step is preparation for your appointment.
What is the point of the consultation? Is it a first meeting, a review of progress, a follow up from a previous meeting? Think, What do I want to get out of this consultation?
Have a clear understanding of your problem if possible. Rehearse what you intend to say.
If you have a complex or worrying problem you may wish take a partner or friend with you to listen so that important information is not forgotten.
Prepare a list of questions you have for the doctor. Give it to them. This way they can figure out best how to answer comprehensively on what they can answer and tell you what they can’t answer.
During the consultation
Try to sit so you can face the doctor either side on or in front of them.
Keep it simple if you can and let the doctor know you have questions to ask, and when is it a good time to ask them.
Maintain eye contact with the doctor, encourage a two way conversation and demonstrate a desire to build a working relationship with the doctor.
Briefly summarise your symptoms.
Ask clarifying questions if you have any uncertainty such as, Why do you advise me to take these medications? Ask if there are alternative treatments.
Answer questions honestly eg if you haven’t been taking your medication as prescribed.
Be positive.
What patients want in a consultation.
Patients want to feel welcomed into the consultation. They want a doctor who shows interest, care and respect for them. A sense of humour may be appropriate.
They want to have eye contact and not just have a doctor who looks at a computer.
They want to be treated in an intelligent adult to adult way. They want the doctor to listen and to have a two way exchange.
They need the doctor to have their notes and be familiar with them.
The patient’s carer also needs to be involved in the conversation.
They need TIME to allow a relevant discussion. Often more than one issue is involved. Test results need to be explained and some patients will want specific information other than “normal” or ” a bit low”. They want options to be discussed and involved in implementing a course of action.
Patients dislike being contradicted over their experience and treatment history. They want their doctor to be frank when the doctor doesn’t know something. They welcome referral or a doctor speaking to someone with more expertise when necessary.
Some patients are very keen to have copies of letters and summaries of the discussion and action plans.
My comment: This patient group has a good structure of the ideal consultation and is similar to the sort of thing that doctors also want. In my experience there are often impediments achieving this. Such things are lack of scheduled time, interruptions, lack of continuity of doctor-patient relationships, difficulty getting notes and getting computers to work. It also helps if patients are focussed on one or at most two main issues and don’t bring a shopping list of everything that bothers them. It is helpful to involve the team of health care professionals so that things that concern eg a podiatrist or a pharmacist can be dealt with separately to the GP or consultant.
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