English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Over 30 years ago Stott and Davis1 described four types of activities in the general practice consultation, in which opportunistic health promotion has a key place (and is still the backbone of the QOF). Five years later, Pendleton2 described a time-sequenced, task-based model of the consultation in which emphasised the importance of exploring patients’ ideas, concerns, and expectations. Neighbour, in 1987,3 saw the process of consultation as climbing a mountain, describing five stages in the ascent. He identified the need for safety-netting, ensuring that future risks to the patient and other diagnoses are considered, and housekeeping, where, after the consultation, the doctor deals with their own feelings. Middleton’s4 process model is not time sequenced, but describes something of what Neighbour called connecting with the patient, and is also a helpful way to look at Pendleton’s ideas, concerns, and expectations in more depth. Middleton acknowledges that both patients and doctors have agendas and that by clarifying both, at least in the mind of the doctor, it is possible to gain a better understanding of the consultation.Silverman et al 5 produced a list of 54 skills to deploy in the consultation, with a consultation framework to put them in. Along with the teaching model developed to train doctors, these skills have dominated thinking on the consultation for 15 years. Chaos theory6 has taught us something about how to deal with complex consultations when the number of uncertainties is high, but there is still a core of consultations that don’t seem to work. How do we make patients change their unhealthy behaviours? What can we do with consultations that repeatedly seem stuck on the same issues: the depressed patient who doesn’t get better, the diabetic …

Coaching for health: holding the curtains so patients can change