Barriers to effective consultations

What are the doctor & patient barriers to effective consultation ?

Examples of doctor factors

  • Lack of time (real or perceived)
  • Inadequate clinical information (lost notes, computer meltdown).
  • Inadequate clinical skills.
  • Inadequate communication skills: eg. talking too much, using too many closed questions, not responding to patient’s agenda, inability to understand and communicate with people from different cultures and backgrounds.
  • Attitudinal problems: boredom, lack of interest in psycho-social aspects of illness, burn-out, stress, fatigue, mental illness, prejudice and discrimination, difficulty handling strong emotions or accepting failure: difficulty coping with threats to competence.
  • Poor recovery from previous stressful consultation or life events.
  • Artificial stimulants.

Examples of patient factors

  • Lack of time (real or perceived)
  • Fear (of doctors, pain and dying)
  • Lack of understanding of basic biology and probability.
  • Unscientific health beliefs.
  • Unrealistic expectations of the health service.
  • Unrealistic expectations of medical science.
  • Inadequate communication skills (over/under assertiveness, inability to speak English).
  • Aggressive attitude.
  • Mental illness.
  • Artificial stimulants.

NOTE – many of the barriers are shared.

Consider aspects such as time management, consultation length, working conditions, coping mechanisms, quality of training.

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