The Cycle of Care

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 it’s 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 it’s effects than it’s processes.
• An effective consultation took account of those factors that resulted in the consultation, such as the clinical history of the problem and the patient’s 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