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The Fatigued Bayley consultation model



We’ve all learned them, sometimes because they pique our interest, sometimes because we wish to consult better. Let’s be honest, most of the time it’s either because a) our trainer was over-enthusiastic and rammed them down our necks, or b) because we had to for the ruddy AKT.

I would like to suggest the Fatigued-Bayley Model for patient consultations

Yes, I’m talking about consultation models.

Whether you’re a fan of Pendleton (not the cyclist turned jockey), or a Calgary-Cambridge, you probably naturally use a version of a consultation model. My own model varies markedly pre and post caffeine. It also tends to be fairly reliant on whether or not the condition could have been managed by two paractemols and/or a plaster.

There is a huge failing however, and that is that our patients aren’t also taught consultation models. Wouldn’t it save time to know they were supposed to be involved in the ‘shared management bit’, or that they needed to wait patiently whilst we were ‘housekeeping’. Perhaps if they realised that ‘addressing health seeking behaviour’ was a fundamental part of consulting, the whole NHS would be in better state. Patient consultation-education would perhaps save time, make things flow a little better?

I propose we all pick one we like and then teach it in schools. Failing that, I would like to suggest the Fatigued-Bayley model for patient consultations: 

1. Arrive promptly

2. Realise doctor is having a bad day, show empathy

3. Concisely describe one problem using medical jargon and if possible an accurate pre-googled diagnosis

4. If asked, undress (the relevant body part) speedily, then dress even faster (consider Velcro)

5. Agree with management plan

6. Thank doctor emphatically (consider full written thanks on arrival home, preferably make it in electronic format for easy upload to appraisal e-portfolio).

7. Leave cheerfully

I obviously abhor all paternalistic practice, but if patients are fully aware of the consultation model to start with then surely this is not a problem, as it’s a partnership. Isn’t it? Think it’d catch on?

Dr Susie Bayley is a GP in Derby and chair of GP Survival