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Enhancing Case Consultations: A Comprehensive Guide by Alya Reeve, MD, MPH

This presentation outlines essential objectives for case consultations, focusing on medical, therapeutic, familial, and spiritual aspects. Participants will explore current case challenges and clarify the purpose of consultations, whether to solve specific issues or create an integrated overview. Elements of individual context, including biological, psychological, and social factors, are emphasized to tailor consultations effectively. The session will also cover strategies for formulating a narrative, gathering pertinent information, and improving the overall quality and usefulness of consultations.

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Enhancing Case Consultations: A Comprehensive Guide by Alya Reeve, MD, MPH

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Presentation Transcript

  1. Consultations & Preparations… Alya Reeve, MD, MPH Continuum of Care DDMI-TUG 4-9-2012

  2. Objectives • Review expectations for case consultations: • Medical, • Therapy, • Family, • Spiritual • Other… • Hear & discuss cases we are encountering in the present.

  3. What Is Our Question? • Clarify the purpose of consultation • Solve a specific problem? • Get an integrated overview? • Help resolve external struggles (team, guardian, specialists, etc.) • Think of important context for presenting a person, at this point in their life. • Age – what are their tasks of living? • What are their physical capabilities? • What are their mental capabilities?

  4. Purpose of Individual Context • BIOlogical – PSYCHOlogical – SOCial • All the conditions of our organism • How has our personality developed? E.g.: • Reactive or observer; expressive; movement oriented? • Flexible? controlling? Passive? Avoidant?... • What are our connections with other people? • Do we have close friends? • To whom do we turn in times of stress?

  5. Formulating A Story • Establish a story (it is made to fit to the time available) • Who • What • When • Where • Provide a timeline (accuracy is important) • Relative to the individual’s lifetime ~ • when did the current situation begin, • how much has it affected their QOL/daily living

  6. Furthering the Story • Give room for new information and hypotheses • Use clarifying questions • Understand purpose of further information (laboratory tests, treatments, interventions) • Purpose: to build to future experience • Prevention of illness • Resolution of problem • New skills and adaptive behavior…

  7. Medical Consultations • One sentence biological descriptor: age, gender, social relationship, position. • Two sentence problem: the issue, timeline; factors tried to address it; results to date. • Current physical state: vital signs; pain. • Past History: all past medical conditions and treatments; active and dormant; development. • Medications: all medications, supplements, and ongoing therapies. • Living situation: housing situation, guardianship, pharmacy, work, leisure, relationships and community activities.

  8. Shall We Discuss Some Cases?

  9. Synergy of ideas & information…

  10. Conclusion • Presentation preparation helps to improve the quality and usefulness of consultations (most of the time). • Communicating results of interactions with consultants • Updating changes since last consultation • Don’t assume continuous historical knowledge • Highlight benefits and bad results (specifics) We are always seeking to improve; there is no perfect.

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