Art of the consultation

Art of the consultation2

History is key
The probability of diagnosis
Words dissect out the diagnosis

There is an art to the consultation and cough is an example.
On the face of it simple.
But underneath there is a myriad of options being handled with each word.History is key2

History is key

The history is key and distils down the cause.
A detective approach using hints and cues.
It is using the golden minute of listening.
Pick up cue words and things that don’t quite fit, refine down.
Distil down to the detail until you have a full picture.

The probability of diagnosis

Tick off each diagnosis in your mind – which means you have to have them in your mind. The probability of diagnosis
The learning is having the full range of diagnosis in the finger tips of your mind. Ask key questions if not there already, but often it is in the history given.
Each word alters the probability of a diagnosis.
The probabilities change with each word spoken.
Like multiple dials on a car dashboard or plane flight deck.
A series of mental swingometers with a diagnosis under each – cancer, asthma, virus, bacteria, COPD, reflux.

Words dissect out the diagnosis

Words dissect out the diagnosis
Duration and frequency is core. How long, when, what is it like, what is the pattern each day.
The ultimate consultation is……
when no specific questions are needed – just asking open questions – tell me more….
Like a surgeon you are cutting down to the diagnosis.
Each word is a scalpel blade dissecting down to the answer.

With thanks to Jo Knight
Quality Improvement expert and sketch note artist @joknight