The ‘Consultation’ is the most fundamental skill in family practice. The core clinical skill of the family physician is the ability to INTERVIEW the patient effectively. Mastering consultation arts is essential for good patient care. The consultation can take place in the primary health care center, the hospital, or the patient’s home.

1. Consultation
Process
in
Family Practice
Ahmed Khairi Mshari
Consultant Family Physician
drahmadtemimi@gmail.com

2. • Consultation Definition
• Characteristic Features of Family
Practice Consultation
• Stages of the Consultation
• Case Scenario

3. Consultation Definition

4. Consultation in Family Practice

5. Characteristic Features of
Family Practice Consultation

7. The Patient’s Agenda
The Patient’s Agenda

8. The Patient’s Agenda

9. Reasons for the Patient’s Attendance

10. STAGES OF THE CONSULTATION
1
• Establishing Rapport Stage.
2
• Diagnostic Stage:
History Taking.
Physical Examination.
Investigations.
3
• Management Stage:
Patient Education.
Prescribing Medication.
Referral.

11. Establishing Rapport Stage

12. To establish an effective rapport, the doctor needs to
consider the following techniques:
Establishing Rapport Stage

13. DIAGNOSTIC STAGE / History Taking
1. Inviting the Patient’s Story.
2. Expanding and Clarifying the Patient’s Story.
3. Establishing an Agenda for the Interview.
4. Creating a Shared Understanding of the
Problem.
5. Generating Diagnostic Hypotheses.
6. Negotiating the Plan.

14. History Taking

15. History Taking

16. History Taking

17. History Taking

18. History Taking
— What do you think is causing your health problem?
— Why do you think that is happening?
— What are you worried that it might be?
— What was the worst thing you were thinking it might be?
— What are you hoping we might be able to do for this?
— How best might I help you with this?

19. History Taking

20. DIAGNOSTIC STAGE / Physical Examination

21. Physical Examination
For medico-legal purposes, the following guidelines
have been recommended for physical examinations:

22. DIAGNOSTIC STAGE / Investigations

23. Investigations
Generally, investigations should be performed
only when the following criteria are satisfied:

24.  The management stage of the
consultation may immediately follow
history taking, physical examination,
investigations, or referral.
 This stage consists of 3 main
processes:
1. Patient education,
2. Prescribing medication, and
3. Referral.
MANAGEMENT STAGE

25. REFERRAL
• One of the main family physician responsibilities is the coordination
of the patient’s care, that is, the organization of health care services
in order to meet the needs of the patient.
• A key element of health care coordination is the referral of patients to
health professionals.
• 5% of patient problems seen in the family practice needs other
medical specialist attention.
MANAGEMENT STAGE

26. MANAGEMENT STAGE / Patient Education

27.  Summarize the consultation and check the patient’s
understanding..
 Chunk and check.
 Give explanation in clear and well-organized fashion.
 Safetynetting.
 Invite questions and ask the patient to write down any
questions to answer later.
 Provide your contact details in case further questions
arise.
 Arrange a follow-up meeting.
 Thank the patient.
Closing the Interview Session

28. CASE SCENARIO

29. CASE SCENARIO

30. CASE SCENARIO

31. CASE SCENARIO