Dysfunctional consultation stands for a situation between a patient and a healthcare worker where the objectives of the engagement are, for one reason or another, not achieved. Some of the reasons for such events would include the doctor’s reputation, emotional turmoil of either party, a large number of complaints, various stressful events affecting the judgment, or a lack of job satisfaction. Factors affecting a dysfunctional consultation can be tied to the doctor or the patient. Physician-centered factors include poor attitudes (doctor-centered care model, burnout), emotional factors (anger, defensiveness, refusal to view the patient as a person, etc.), weak consultation skills, poor knowledge of the subject, and a lack of interest in the patient’s wellbeing. Patient-centered factors include language barriers, partial or complete deafness, emotional baggage, psychiatric diseases, a lack of trust in doctors, immoral behavior, and other issues.
Some factors can be related to the interaction between both parties.
These include cultural issues, the presence of hidden desires and attempts to look good, fears and expectations, as well as the failure to identify them. Finally, dysfunctionality can be induced by the failure to create a treatment appropriate to the patient’s situation. Besides these, there are practice factors involved, such as time constrictions – patients or doctors may not have enough time for an appointment. Communication systems, such as telephones and the Internet, may not be present, making consultations harder. Interruptions and poor staffing may reduce the quality of the consultation and keep the doctor and the patient distracting. Finally, the environment of the office may not be conducive to treatment, making either of the parties uncomfortable and unable to concentrate.
Effecting consulting of patients is a skill that can be learned. Beginners may have to rely on a single model of operation to ensure passable results in most situations. It should be kept in mind that the process of a consultation is not a physician-centered activity but rather a dialogue between an expert in medicine (the doctor) and an expert in their own body (the patient). Advanced practitioners may be able to tailor consultations to individual patients and their needs.