SEMINAR TRAINING FOR CONTRACEPTIVE CARE – DOCTOR AND PATIENT’S AGENDA REVISITED
Thinking about the consultation makes the doctor aware of the differences between his or her agenda and that of the patient. Opportunities can then be made for the patient to express her or his own ideas and anxieties. The patient’s agenda may consist of fairly straightforward questions that are easily asked provided the doctor allows enough silence and space. Some anxieties are too personal or embarrassing to be broached directly, and the variety of calling cards and presenting symptoms is well known. Such calling cards are particularly common where the underlying anxiety is to do with sexual matters, and contraceptive problems are one of the commonest presentations. However, many underlying difficulties are even less conscious, and may only be guessed at by recognizing inappropriate or inconsistent behaviour. The doctor’s agenda might include a wish to understand some of this behaviour, for instance, what makes it impossible for a couple to find any effective method of contraception, or why a young girl is asking for her third termination. What skills does the doctor need in order to be able to explore such matters, and how may these skills be obtained?
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