The Cycle of Care

The cycle of care describes the antecedents and consequences of each consultation for the doctor as well as for the patient.

  • Medical care is part of everyday life and each consultation has a CONTEXT.
  • The sequence of events leading up to the consultation influence it’s context.
  • The consultation, in turn, has an impact and influences subsequent events for both the doctor and the patient.
  • A successful consultation was defined more by it’s effects than it’s processes.
  • An effective consultation took account of those factors that resulted in the consultation, such as the clinical history of the problem and the patient’s interpretation of events

1) Factors pre-consultation

  • Doctor – mood; health; time; organisation issues.
  • Patient – problem for the doctor; ideas, concerns and expectations; positive and negative reactions [subsequent consultations]

2) THE CONSULTATION

3) Immediate Outcomes

  • Doctor – rewards; punishments; doctor satisfaction.
  • Patient – commitment to plan; patient satisfaction; memory; change in concern.

4) Intermediate Outcome

  • Doctor – patient feedback
  • Patient – adherence to plan

5) Long term Outcome

  • Doctor – job satisfaction
  • Patient – change in health

6) This feedback loop then affects UNDERSTANDING:

  • Doctor – values, beliefs and attitudes; skills and experience; emotional and behavioural factors.
  • Patient – values, beliefs and attitudes; skills and experience; emotional and behavioural factors.

7) Feeds back to 1).

The patient can EXIT from the cycle:

  • No care
  • Self care
  • Alternative care
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