Identifying the Real Reason for Attendance
The "Odd" Consultation
If you haven’t already experienced this, you will at some point. Sometimes a consultation feels ‘odd’ - the patient may seem uninterested or unsatisfied with your suggestions, or there may not be a clear question or problem.
In these cases, consider going back to your consultation models:
| Model | Key Concept |
|---|---|
| Calgary-Cambridge | The ‘Expectations’ part of ICE (Ideas, Concerns, Expectations) |
| Balint | The ‘ticket to entry’ - what brought the patient through the door? |
Common Scenarios
Sometimes the symptom offered isn’t the primary concern, but rather something tangential:
| Scenario | What’s Happening |
|---|---|
| Surgery/QOF Recall | Patient contacted by reception, has no specific issue, doesn’t understand why they’re there |
| Unexpected Ideas | Patient doesn’t understand why you aren’t discussing conditions they’re worried about (eg: blurred vision, eye cancer concerns) |
| Wrong Department | Patient doesn’t realise you don’t handle their problem type (eg: blue badge applications, dental problems) |
TIP
Always clarify early: “What were you hoping I could help you with today?”