Try changing consultation styles

Opinion

By Ms Beryl de Souza, plastic surgeon, associate postgraduate tutor for Central North West London, and honorary secretary of the Medical Women’s Federation

The patient who seeks treatment in the private sector can sometimes be very demanding and challenging.

In these situations, you might need to think about changing your consultation style. I have found using the health coaching approach in consultations is an excellent way to support decision- making.

The coaching methodology was first used in the post-war period in the sports industry and this has now transferred into business and performance coaching.

These concepts are now used in healthcare too, focusing on individuals to provide insight and awareness of health goals and increasing patient responsibility for managing their own health rather than to find solutions directly.

It is a skill that involves:

• Active listening;
• Appropriate questioning techniques;
• Support for decision-making without direct guidance other than trying to find solutions.

Patient-centred approach

Health coaching moves us to a more patient-centred approach, empowering patients to take responsibility for their care through exploring their goals, looking at the options available to them and reflecting on the consequences of their options.

The three elements that a doctor can offer to support health improvements using a coaching style is through:

• Health expertise/knowledge;
• Health advice/recommendation;
• Behavioural change interventions.

A good health coaching conversation hinges on the belief that the patient has the potential to solve their own problems contrary to the traditional approach where the doctor is the problem-solving expert.

The health coaching style encompasses a continuum approach and uses tools to raise a patient’s awareness of their health issues and increase their personal responsibility for solving them.

There are a number of health coaching models and tools developed to support health professionals.

The IGROW model, developed and promoted by Sir John Whitmore, is the most widely known and validated. This model can be used in a ten-minute consultation with appropriate training and practice by being clear, concise and positive as you introduce the coaching conversation.

The IGROW coaching model

I – What is the issue?
Goal – What do you want to change/achieve from this consultation?
Reality – What is happening now? Tell me about the current situation;
Options – What could you do differently? What might get in the way?
Way forward – How committed are you?

Independent practitioners of today have to be versatile and adaptable to different consultation styles and the coaching style consultation is one to embrace.

If you have not done so already, I recommend you seek out a training course or read more about it.

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