AGENDA SETTING

 ·        Reduces uncertainty for the patient and the doctor

 ·        May allow more efficient and effective use of time

 ·        Gives more chance for the patient to raise other concerns and identify the most important concern she wishes to explore on this occasion

 ·        Encourages negotiation and mutual partnership

 STRATEGIES

·        Listen to the first problem and allow some of the story to come out.

If you interrupt too soon, the patient will “go back” to the first problem

·        Summarise the problems and check that you have heard and understood them correctly 

·        Acknowledge the problems; show concern verbally and non-verbally

·        Ask for any other problems (this reduces the chance of the patient raising a “late” problem) 

·        Prioritise the problems - negotiate which one(s) you will explore on this occasion) 

USEFUL PHRASES

“What’s the first thing you’d like to discuss…..?”

“What’s the one most troubling you…….?”

“Which one shall we tackle/focus on first?”

“Which is the one most important to you?”

“Let’s start going through them and see where we get to…..”

“How shall we take this forward?”

WHEN SHORT OF TIME AND RUNNING LATE

“sorry I am running late (neutral tone)……..” and then negotiate where you aim to go together in the rest of the time available, as above.

 “We’ll try to deal with as many problems as possible….depending on time/how we get on….”

“We’ll try to do justice to as many as we can.”

“I want to give enough time to each of these problems…..”

“Let’s get on and see how we go…..”

“OK, let’s see what we can do today….”

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