By Peter Worrall, Adrian French, Les Ashton

What distinguishes the consulting of skilled kinfolk medical professionals from their newly certified colleagues? The query is frequently frustratingly tough solution basically or objectively: in contrast to many professions, kinfolk medical professionals face a dearth of transparent expectancies of what constitutes complicated perform, a scarcity of outlined criteria opposed to which to judge it, and a scarcity of expertise-related expert education during which to enhance it post-certification. The version of session excellence defined during this publication illustrates in functional phrases how complex consulting should be nurtured. It avoids tantalising price judgement comparable to 'excellence'. as a substitute, it describes behaviours in phrases that may be saw each day, delivering an in depth photo of what constitutes complicated consulting behaviour, how kinfolk medical professionals might be helped to procure those larger degrees of craftsmanship, and the way alterations in behaviour will be pointed out and evaluated. "Advanced Consulting in relations medication" is written in guide shape for simple entry and use, and offers an essential imaginative and prescient of upper order relatives health practitioner consulting.

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Extra info for Advanced Consulting in Family Medicine: the Consultation Expertise Model

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It can be seen in the many agents or influences that may affect a consultation. Some agents are physically present including the doctor, patient, and others, such as a nurse or relative . . [it’s] suggested the manager, lawyer, statistician, journalist, and computer have agency within a consultation. ’ 18 There are of course many other influences on the consultation, some local, some national. These are real influences affecting what happens between patient and doctor, imperatives that come from practice policies, funding agencies, media scares and so on.

15 Medical Competence – domain segment 4 0 A D VA N C E D C O N S U LTI N G I N FA M I LY M E D I C I N E However empathic and receptive a doctor may be, s/he is not effective unless applying sound, evidence-based, scientific medicine. But expertise involves more than simply having enough medical knowledge to practise safely. Even the most expert consulter has gaps in his/her knowledge or is unsure of the quality of that knowledge or the judgements made. The skill involves knowing how to apply this knowledge, having the ability to assess the quality of personal knowledge and judgement, identifying possible weaknesses and creating strategies for addressing them.

32 Medical Competence requires professional confidence and self-awareness gained through experience. So a new entrant might be clinically highly competent but not be medically competent in the sense we use it here. Medical Competence as applied in the Consultation Expertise Model goes beyond being medically up to date; it is about how medical ‘knowhow’ is applied. MEDICAL COMPETENCE – IN MY EXPERIENCE A 43-year-old woman attended surgery four days after a bout of sickness and diarrhoea. She was seen by a partner, fully examined and told she had a post-viral illness.

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