Background:
According to wright and McAdam 1979, consultancy is the occasion in which a person who is ill or believes to be ill seeks the advice of a doctor whom he or she trusts. Good communication between a doctor with the patient has a significant role in the patient’s health and has been regarded as a placebo and can have an impact like a drug. Not only communication but the doctor needs to be guided in their attitude (i.e., empathy, compassion, and care) and they need to be cooperative and demonstrable in their skills.
Objectives:
The objectives of this research were to study:
General Objectives:
1) To find out the current consultation skills of doctors in Northwest General Hospital Peshawar.
2) To find further ways through which the current consultation skills of doctors can be improved.
Specific Objectives:
i. To find out whether the basic skills of physicians are practiced in tertiary care hospitals of Peshawar or not.
ii. To assess in which age group these skills are more practiced and in which group they are mostly neglected.
iii. To assess those specialties and gender in which they are practiced or neglected.
Methodology:
A cross sectional study was carried out among the consultants of Northwest General and Teaching Hospital Peshawar. As we were using the census method, so all the consultants at northwest general and Teaching hospital Peshawar were included. Ethical approval was granted by the college Ethical approval committee. Consent was taken from the Hospitals’ Director of Medical services before the data collection as well. Before the data collection oral consent was also taken from each consultant. Information was obtained by observing the consulting skills of each consultant for 5 patients using the SEGUE framework. After that, we marked the questionnaires ourselves.
Results: In our survey study, Male consultants were 78.1% and 21.9% were females. The mean score of consultants was good i.e. 24.81±4.11. Comparison of scores between male and female consultants showed slight difference. Mean score for males was 25(SD 4.40) and females 24.14(SD 4.01), with the p-value of 0.646 (not significant). However, there was difference in the scores of consultants above the age of 50 and below i.e. 26.92 (SD 2.53) and 23.36 (SD 4.66) with the P-value of 0.018(significant). The highest score was recorded for 2 items that are “elicits the patients’ view of health problem” & “Explores physical and physiological factors” i.e.31 (96.9%). While the lowest was recorded for one item that is “makes a personal connection during the visit” i.e. 9 (28.1%).
Conclusion: In our study, the young doctors were comparatively following more steps of the SEGUE framework as compared to the older ones. There were some items which the females followed more like showing empathy to the patient, outlying their agenda, encouraging the patients to ask questions, adopting to the patients understanding and providing instructions. While the males were also good at certain like explaining and outlying the treatment options and preventing the risk factors. To further improve we highly recommend that special training courses should be arranged at undergraduate and post levels. Also, the burden on tertiary care hospitals needs to be reduced.
Keywords: Consultation Skills, Doctor-patient relationship, SEGUE Framework.
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