Reflection_Using_Driscoll

The use of models gives structure to our consultations. Neighbour (1987) talks about models turning up everywhere, sometimes in forms that we do not recognise as being a model at all. A recipe is a model of a sequence of things to do if you want to make a cake. Maps are models of the real world. They allow us to cut down on our exploring time and we learn from the experience of the map makers. A map is one example of a model of all the possible journeys you could make. When you apply these analogies to medicine the classification of consultation models are; Doctor centred, task orientated, patient centred and behaviour orientated approaches. The difficulty with medical models are that the ones that tell you what to do don’t tell you how to do it, and the ones that concentrate on how to speak and behave towards a patient can make you lose track of what you are trying to achieve. When applying the above to Roger Neighbours model of consultation the consultation becomes a journey, with five checkpoints to be visited along the way. WHAT The purpose of returning to this situation is to critically analyse my decisions made specifically with regard to the management/treatment of the patient’s diagnosis. The child had attended with her father who had come with a very specific plan of what he expected from the consultation. He had already diagnosed his daughter as having a bacterial throat infection that must be treated with antibiotics. The patient was quiet and it was her father that started the conversation before they had even sat down. It was clear that a simple disease/illness model approach to the consultation wasn’t going to be appropriate as I immediately became aware that that I had to break down the fathers’ pre conceived ideas that had created a barrier before the consultation had even begun. SO WHAT The positive aspect for me from this reflection is that it will increase my confidence in not allowing myself to be pressured into prescribing antibiotics when they are not indicated. I had made the correct decision as per guidelines but at the same time ensured that the reasons for the clinical decision had been understood. When the consultation was discussed with my mentor he had agreed that I had made the correct decision and added that as per Neighbour (1987) I had successfully negotiated and influenced the father through education rather than allowing the father to be the dominant person in the consultation and that I had acted in a responsible but sensitive manner. NOW WHAT