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 its 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 its effects than its processes.
- An effective consultation took account of those factors that resulted in the consultation, such as the clinical history of the problem and the patients 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