A care delivery process encompasses the following tasks: assessment, diagnosis, planning, and implementation. The practice of family medicine also incorporates these aspects of care process in care delivery efforts. This paper seeks to analyse health care delivery process practised in family medicine. To start with, consultation constitutes the main aspect of care delivery process in family medicine. There are several models of consultation used in family medicine practice. The Calgary Cambridge Model is the most widely employed model of consultation in family medicine practice (Bleakley, 2014). The model basically outlines five steps in conducting a consultation (Thomas & Haynes, 2005; Gray & Moffett, 2011). These five steps include the following: initiation of the interview session, gathering of information, conducting physical examination, planning and giving explanations, and closing the interview session (Lyons, Caesar, & McEwen, 2007).
The first step of Calgary Cambridge Model, initiating the session, involves establishing the initial rapport and identifying the reasons for the consultation (Orey, 2015). Establishing initial rapport involves greeting the patient, doing the introduction, and demonstrating respect to the client. To identify the reasons for the consultation, one is required to identify the patient’s problems, listen attentively to explanations given by the client, especially the clients’ opening statements, and negotiate the agenda of the consultation. The case study does not provide explanations on how the consultation was conducted. However, the fact that the patient was visiting the general practitioner for the second time implies that the general practitioner had established a rapport with the patient and had won the client’s trust. Besides, there is evidence that the GP use a specific model to conduct the interview.
Calgary Cambridge Model could be applied by the GP in the case study to conduct the care delivery process. In this case, the GP could break the consultation into five steps according to the Calgary Cambridge Model. In the first step, the GP would aim at establishing rapport with the client and identifying reasons for the consultation. In the second step, the GP would seek to explore the patient’s problems and understand the patient’s perspectives concerning the problem. The third step would involve the designing of the organisation overt and attending to the flow of the consultation process. In the fourth step, the GP would build relationship with the client by developing rapport, using appropriate non-verbal behaviours, and involving the patient in the consultation process. In the next step, the GP should focus on providing the appropriate information in correct amount. Besides, the GP aid in accurate recall and understanding and make decisions shared with the patient.
Patient-centred approach to care is advantageous in several ways. First, it ensures that the needs of the patient are well taken care of. Secondly, it helps improve patient outcome by promoting medication adherence in patients. Patient-centred approach to care also helps in strengthening between the patient and the care provider. In the case study, the GP uses patient-centred approach in delivering care to the patient. This evidenced by the fact that the GP takes cognisant of the patient’s concern and incorporates them in the interventions given.
Different methods can be used to gain patients’ ideas, concern, and expectations (ICE) during consultation. Basically, the following consultation skills can greatly help in gaining the patients ICE: Welcoming, listening, questions, response, and explanations. While welcoming the patent, the GP should make the patient feel comfortable from the onset. Besides, the GP should show adequate respect by paying full attention to the patient. For instance, the GP should not be taking notes when the patient enters the office. Rather, he should be sit up and listen to the client keenly. While responding to the patient, the GP should clarify points, summarize and reflect the statements and feelings expressed by the patient. The GP also needs to listen attentively to the patient during the consultation. In this case, the GP should maintain eye contact with the patient.
The manner in which questions are phrased can greatly help gain patients’ ideas, concern, and expectations. For instance, the following phrase can be used to ask about the patient’s ideas: “Could you tell me about what you think might be causing this stomach ache?” (Cole & Bird, 2014, p. 29). On the other hand, the following example gives a phrase that can be used to ask about the patient’s concern: “I would like to know what concerns you most about the pain in your stomach” (Cole & Bird, 2014, p. 30). Lastly, the following phrasing can help ask about the patient’s expectations: “In what ways do you think I can be of most help to you?” (Cole & Bird, 2014, p. 30). In the case study, the GP asked the patient questions related to the pain. In this case, it can be assumed that the GP asked about the patient’s perception of the cause of the pain. Besides, the fact that it is stated that the GP considered the patient’s preference in management shows that questions about the patient’s concern were asked.
According to the case study, the patient’s idea about the cause of the pain was that it was attributed to the previous pain episodes for which the patient had sought help from the GP. On the other hand, one of the concerns of the patient was that the pain might affect his ability to continue working as a mechanic. In the case study, the patient’s perspectives about the problem were taken into consideration and taken used in planning for care. After listening to the patient’s perspective about the problem, it is important to incorporate them in planning the management of the condition. Listening to the patient’s perspective greatly helps in ensuring that the main concerns of the patient are given priority. Giving priority to the client’s concerns greatly helps in ensuring that they are satisfied with the care given. Indeed, the patient in the case study was satisfied with the care given after visiting the GP.
There is a continuous and care relationship between the patient and the GP as evidenced by the fact that the patient had visited the GP before. During the patient’s first visit, he complained of pain in the distribution of the median nerve. There is adequate evidence of continuity of care in the case study since the GP and patient have had a caring relationship before. The GP also seem to be working towards strengthening this relationship by approaching the care delivery process from a holistic approach. For instance, during the patient’s second visit, a comprehensive medical examination and routine checking were conducted. It is likely that the GP has deep insight into the patient’s history. Continuity of care relies heavily on patient records since the patient is likely to visit one particular GP on several occasions. During each visit, the patient history comes in handy. In other words, all records concerning the patients are used in care services rendered to the patient at all times. Therefore, there is the need for keeping the records. However, the case study does not indicate that certain records were used to inform the care process in during the patient’s second visit.
The condition of the patient in the case study is likely to affect his family in certain ways. First, the condition may deprive him of the ability to do his job as a mechanic since the condition is affecting his elbow and the nature of patent’s job demands that one should use one’s hands in executing various tasks related to the job. As a result of reduced ability to perform his job, the patient may not be able to provide adequately for his family. Secondly, the condition may also affect his ability to execute simple tasks on his own. He may have to depend on his family members for assistance on the simple tasks. This may put a heavy burden on the family members. Consequently, it may also affect the psychological status of the family members. The family doctor can play a major role in helping the patient and the patient’s family deal with the present illness in several ways.
First, by administering the appropriate intervention to the diagnosed problem, the family doctor can help reduce the symptoms and facilitate recovery. Secondly, the family doctor can talk to the patient’s family about the adjustments that they should make to their lives to accommodate the client’s condition and to help him deal with the condition. In this case, there is the need for educating the patient’s family members on their role in providing care to the patient. For instance, the family doctor can educate the family on the need to remind the patient to take his medications and the support needed by the patient.
The patient must comply fully with the prescribed medications to realise their full benefits. However, failure to comply with the medications might delay the recovery process or worsen the problem. As a matter of fact, failure to comply with the medication fully may lead to hospitalization of the patient in some cases. In turn, hospitalization may cause the patient to incur higher cost on the care services. A GP can play a significant role in promoting patient adherence to medications prescribed. In the case study, the GP emphasizes to the patient the need to visit the GP for follow-up. This would help the patient in complying with the medication regimen given for his condition. In the subsequent visits, the GP can find out whether the client is complying with the medication regimens given or not.
The case study indicates that the patient has used comprehensive approaches to assess the problem of the patent. In this case, the GP performs musculoskleton examination as well as the quick medication examination. Routine checking is also conducted to help identify all actual and potential health problems that the patient might have. The GP also asked the patient questions related to the patient’s pain. The information provided by the client informed the conducting of the full musculoskeletal examination. In general, the GP in the case study employed adequate approaches to gather the necessary information to guide the care delivery process to the patient.
Diagnosis in family medicine is personalized. Therefore, assessments take a holistic approach. Since the case study deals with family medicine, the GP takes a holistic approach to conduct assessments. Another feature of family medicine is that patients’ contribution is highly recommended. In the case study, the patient’s concern informs the decisions made by the GP to a great extent.
References
Bleakley, A. (2014). Patient-centered medicine in transition: The heart of the matter.Top of Form
Cole, S. A., & Bird, J. (2014). The medical interview: The three function approach.Top of Form
Gray, C., & Moffett, J. (2011). Handbook of Veterinary Communication Skills. Hoboken: John Wiley & Sons.
Lyons, N., Caesar, S., & McEwen, A. (2007). The appraiser's handbook: A guide for doctors. Oxford: Radcliffe Publishing.Top of Form
Orey, M. C. (2015). Communication skills training.Top of Form
Thomas, M., & Haynes, K. (2005). Clinical risk management in primary care. Abingdon: Radcliffe.Top of Form
