The consultation

Abstract

We know this to be true politically, in unhappy marriages and in many other spheres of life. However there is evidence that this is just as true in the medical setting as it is in ordinary life. The area of medicine where we communicate or try and communicate with our patients is the consultation. Spence in 1960 wrote "The essential unit of medical practice is the occasion when in the intimacy of the consulting room or sick room a person who is ill or believes himself to be ill seeks the advice of a doctor whom he trusts. This is the consultation and all else in the practice of medicine derives from it" So if the consultation lies right at the heart of all that we are trying to do as doctors it is right that we look at it, analyse it, study where we fail in it and try and do it better. There are several ways in which we can look at the consultation - several models which we can use to analyse it. First of all there is the medical model.