Effective Strategies

GP trainees often ask how they can effectively steer/direct consultation at risk of losing focus without offending patients or appearing rude. It is essential to acknowledge that a good GP consultation often straddles a delicate balance between the patient’s and the doctor’s agenda.

Here are some strategies you can employ to steer your consultation when needed.

Avoid Abrupt Interruptions

• Allow time for open questions without interruptions at the beginning of the consultation
• ICE effectively
• Then attempt to gather more specific information that will enable you to filter down the differentials and explore red flags

Patients value feeling heard and cutting them off abruptly may damage rapport. Instead, you can use phrases acknowledging the patient’s concerns while allowing you to regain control of the consultation. This demonstrates empathy while refocusing the discussion.

• Example: “I understand this is really important to you, James, and I want to make sure we explore that later. For now, can I ask a few specific questions to ensure we don’t miss anything crucial?”

This approach reassures the patient that you’re not dismissing their concerns but prioritising their health and safety by ensuring comprehensive care.

Focus on the Presenting Issue

Occasionally, patients raise multiple concerns, and it is essential to manage the consultation time efficiently. Here, refocusing on the primary presenting complaint is critical.

• Example: “I see you’ve mentioned a few different issues today, James, and I want to ensure they all get the attention they deserve. Why don’t we focus on your breathing issue first, and we can arrange another appointment to address the other concerns?”

This approach allows you to keep the consultation on track while offering the patient a clear plan to address other concerns later, reinforcing that they won’t be overlooked.

 Prioritize the Most Serious Concern

If the patient has multiple issues, you can prioritise by addressing the most severe or pressing condition.

• Example: “You’ve been dealing with several issues recently; Amanda and I understand that can be overwhelming. Let’s focus on the most urgent concern, which is your diabetes control today, and we can address the others in a follow-up appointment.”

This response shows the patient that you are taking their health seriously while ensuring that the most critical issues are addressed in the available time.

Key Takeaways

• Empathy and acknowledgement: Always acknowledge the patient’s concerns before steering the conversation.
• Clear communication: Use clear and polite language to explain why you need to shift the focus.
• Balancing concerns: Let the patient know their concerns are significant but prioritise what’s urgent.
• Offer follow-up plans: Reassure the patient that any remaining issues can be addressed in a follow-up consultation if needed.

These strategies will help you manage time effectively during the consultation. It will ensure you gather the necessary information while maintaining rapport whilst comprehensively addressing the patient’s most pressing concerns.

Dr Sakaria Farah
PassCME SCA Tutor