A holistic consultation is like sitting on a beach talking to a friend.
People often ask me, ‘How can you practice holistically in general practice when you have so little time?’ I think they mean attend to all the physical ailments and include their mental and emotional well being, while also taking into account the social and environmental factors.
Firstly, it is good to be in the mind-set that 10 minutes is plenty of time. It helps me feel relaxed and comfortable.
For patients it is important they feel that they have time to tell their story. So an opening question like, ‘Tell me what can I do for you?’ allows them to go through things in their own way. I listen, attentively without interrupting. Curiously most patients will complete what they want to say within 3 minutes.
I will then ask some specific questions about their condition so I can begin to formulate what the problems are. They may need examining to help with a diagnosis.
I will have already checked on the computer their past medical conditions and drug medication before the consultation. In most cases I will know something of their family and social situation as I have been in the practice for 30 years.
I can now think how to manage their issues and give information and advise.
When all this is done I may ask how they feel about what is happening, or why they feel this may be happening to them now?
And perhaps some time for social conversation, the weather and news.
All done in 10 minutes. Well it is possible, but if not I can ask them to come back for another appointment.
Often for difficult emotional consultations I say nothing and just listen. Often when leaving they will say, ‘Thanks very much doctor for all your advise.’ -a very satisfying consultation for both of us.
