Delighted to be living the lifelong career ambition: Roger Neighbour is presenting on the Consultation for our VTS.
Wonderful stuff. #MedEd
Patient centredness: not doing all that the patient wants, but putting all of your skills, expertise and attitude at the disposal of the patient.
This does require a skilled application of structure within the Consultation
The greatest opening line heard by Roger Neighbour:
(From the mouth of an Orthopaedic Consultant)

Tell me what you need me to hear, in your very own words.

Subtle, nuanced, appreciative enquiry!
#CIAN
Steering between the parts of the consultation, as we would with non-clinical conversations. Key aspect of consulting to move through each part:
By all means appreciate the development of the full picture, but after a couple of minutes you’ll need to move along the path:
#ConsultingInANutshell
Ways of Steering the consultation:
Signposting
Summarising
Turn a receipt
Suggesting
Checking
Practical phrases & application of doing this smoothly.
Genuinely shared decision making:

THINK OUT LOUD
Thinking out loud:
This helps to explain the justification as to each possible course of action.
Many possible & justifiable choices and how these are communicated, tailored to your perception of their preferences, which are confirmed or clarified by the patient’s response.
AKA:

Show your means of reaching the conclusion you’ve come to.
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More from @ArtfulDoctor

30 Mar
Today during my on call I was asked to review the following case. The parents have given their consent to discuss via social media for educational purposes:

The case of the blue willied boy.

A thread 🧵
...The child in question was very upset and complained to his teachers that to his great surprise and distress that his willy was blue.
No other symptoms, no pain, going for wees without difficulty.
No fever, no cough and no change in smell or taste.
Sorry, force of habit. 🧵
So the understandably concerned teachers required a visual confirmation of the blue willied boy’s claims: cue call to parents, resulting in my involvement.
🧵
What was the cause?
Trauma?
Venous congestion or engorgement??
Torsion???
Read 9 tweets
25 Feb
From @TARGETabx toolkit on @rcgp website- prescribing of ABx has been creeping up since the turn of the century- it's a popular misconception that ABx were only overprescribed in the bad old days...! But there's been better news recently...
The response to this? #ESPAUR
#AntibioticGuardian #KeepAntibioticsWorking
The picture before a focussed commitment to tacking antimicrobial prescribing for a 5 year period. Bit of local flavour for context for our @MidRCGP AiTs
How it was going...
Read 13 tweets
7 Feb
#SuperBowl
#NFL Teams as English #PremierLeague teams: A thread
Disclaimer: this may wind you up with some tenuous links... post your ideas as comments!
1/8
Dallas Cowboys:Arsenal
Wins in the 70s & 90s but some way off those glories in recent years. Still up there with the best
#SuperBowl
#NFL Teams as English #PremierLeague teams: A thread
Disclaimer: this may wind you up with some tenuous links... post your ideas as comments!
2/8
New England Patriots:Chelsea
A 21st Century explosion of titles putting any previous history into paler comparison.
#SuperBowl 
#NFL Teams as English #PremierLeague teams: A thread
Disclaimer: this may wind you up with some tenuous links... post your ideas as comments!
3/8
49ers:Man Utd
Red, black & gold brand transcending the sport, once truly dominant, not so in recent years. Still up there
Read 9 tweets
16 Jan
#ExploringGPwithUoB
@gmcuk National Training Survey data on Satisfaction in Speciality Training.
Every year the question was asked:
GP Trainees highest satisfaction rates.
Credit to the investment made by GP Trainers & Programme Directors
#ExploringGPwithUoB
Patients are rather satisfied with us too.
A Proud history of high satisfaction in comparison to the NHS over the years; up to us in Primary Care to maintain this:
Read 6 tweets
20 Dec 20
#CIAN
#ConsultingInANutshell
A definitive thread, with a message from the author ✍🏼
1/8
#CIAN
#ConsultingInANutshell
The First Chapter: As We Begin
Setting out the way ahead, navigating through the main parts of the Consultation
2/8
#CIAN
#ConsultingInANutshell
Next Chapter: The Big Picture
Start with the ‘Why?’
Is it about the CSA or something wider?
Linking those 3 parts from the last chapter, broadening the approach
3/8
Read 9 tweets
29 Nov 20
When we’re Centred, we find comfort, confidence and serenity, choosing wisely our next intention.
In times of adversity we focus on those aspects at our core that make the most difference.
When the winter comes it’s the most important time to keep the fire burning 🔥
#CENTREDPrimaryCare
Pattern recognition, guiding patients towards evidence-informed choices takes time, skill, experience and clinical intuition.
This is why Continuity can offer an advantage as evidenced by outcomes & admissions.
Due credit to those doing this in one encounter!
Read 7 tweets

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