The Singapore Family Physician

Back to issue Vol 44 No. 1 - The Extended Consultation

Overview of the Extended Consultation Model

Cheong Pak Yean, Ong Chooi Peng, Goh Lee Gan
The Singapore Family Physician Vol 44 No 1 - The Extended Consultation
6 - 8
1 January 2018
0377-5305
In the usual medical consultation, history taking, physical examination, and investigations lead us to a diagnosis list from which management ensues. When the patient’s problems need further exploration of the mind. We can extend the medical consultation beyond the biomedical to include psychosocial dimensions. The usual clinical methods of history, examination and investigation may be extended by various tools. History is extended by the use of three tools: the time-line of events in the patient’s life; the family genogram including recent changes; and the Johari window. Examination of the patient physically may be extended by reflective communication. Just as we investigate the body by various tests, we also investigate the patient’s thinking processes using Socratic inquiry techniques. Based on the information collected, we arrive at a 4P’s formulation of the patient’s problem(s). We can then integrate one or more of the 4P’s of psychosocial work into the usual management.