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How your feelings affect your consultations

Dr Peter Tate offers some food for thought on how values, beliefs and your own self-esteem can make a difference to how you treat patients

Dr Peter Tate offers some food for thought on how values, beliefs and your own self-esteem can make a difference to how you treat patients

Like patients, we bring to our consultations a set of beliefs, moral values and attitudes that are derived from our own upbringing, culture and experience. These thinking and feeling patterns will influence how we consult with our patients. A few simple examples illustrate this point.

•If I am an atheist, I am less likely to suggest to a dying patient that they should seek solace in God.

•If I believe in the total sanctity of human life, I am never going to recommend a termination of pregnancy or be involved in discussions about euthanasia.

•If I am politically left of centre, free market health service policies may be anathema to me, and I may work in such a way as to demonstrate my disapproval.

•If I believe that unsolicited lifestyle advice is an intrusion into personal liberty, I am not going to offer it very often, or if I do it will be half-hearted and only because I get paid to do so.

• If I believe my job is to diagnose serious illness, I am likely to believe that my patients' ideas and worries are relatively trivial.

•If I believe it is better for patients to be protected from the whole truth in serious illness, I will withhold information.

•If I believe that the patient's ideas and concerns are important, then I will seek them out.

Beliefs and attitude
How do your own beliefs and attitudes affect the way you consult or feel about patients? Can you compromise? Can you justify your attitudes to yourself and your peers? Do you have an accepting attitude to your patient's point of view and beliefs, or is it a judgmental attitude which equates your patient's worth with their knowledge and beliefs, and places your point of view above theirs?

Self-esteem
Our self-esteem is relevant. What is our status? How important is status to you and how motivating is it? Do you need to be powerful to protect your fragile self-esteem? Do you consult with patients in a way that enhances your self-esteem, or is this not too important to you? How important is the approval of your friends and peers? How do you maintain your self-respect when dealing with patients? How do you develop self-confidence?

Think about it.

Dr Peter Tate was a GP in Abingdon, Oxfordshire, for 30 years and is a former convenor on the RCGP's panel of examiners.

This article is an adapted extract from Dr Tate's new book The Doctor's Communication Handbook, fifth edition, Radcliffe Publishing, 2007, ISBN 1-84619-138-6. To order, go to www.radcliffe-oxford.com

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