What are the doctor & patient barriers to effective consultation ?
Examples of doctor factors
- Lack of time (real or perceived)
- Inadequate clinical information (lost notes, computer meltdown).
- Inadequate clinical skills.
- Inadequate communication skills: eg. talking too much, using too many closed questions, not responding to patients agenda, inability to understand and communicate with people from different cultures and backgrounds.
- Attitudinal problems: boredom, lack of interest in psycho-social aspects of illness, burn-out, stress, fatigue, mental illness, prejudice and discrimination, difficulty handling strong emotions or accepting failure: difficulty coping with threats to competence.
- Poor recovery from previous stressful consultation or life events.
- Artificial stimulants.
Examples of patient factors
- Lack of time (real or perceived)
- Fear (of doctors, pain and dying)
- Lack of understanding of basic biology and probability.
- Unscientific health beliefs.
- Unrealistic expectations of the health service.
- Unrealistic expectations of medical science.
- Inadequate communication skills (over/under assertiveness, inability to speak English).
- Aggressive attitude.
- Mental illness.
- Artificial stimulants.
NOTE – many of the barriers are shared.
Consider aspects such as time management, consultation length, working conditions, coping mechanisms, quality of training.