Using a patient-centred structure for effective telephone consultations

7th April 2021

GatewayC and the Maguire Communication Skills Training Unit have partnered to produce this resource below. 

We’ve all experienced the “doorknob disclosure” when the really important thing is only disclosed as the patient is leaving. This is doubly difficult to manage on the telephone where visual cues to the unspoken “something else” are not evident. This situation can be largely avoided by using a patient-centred consultation structure (whether face-to-face or on the phone).

Various evidence-based structures can be found in the literature (for example in Silverman, 2013) and the principle underpinning all of these is:

Gather All and Acknowledge All before Giving.

The acronym ENGAGE can be used as an aide-memoire.

Why gather all?

Gathering concerns enables us to find out the patient’s priorities. We can then tailor the information given more appropriately.

Any information-giving inhibits the patient from sharing further concerns.

Patients who are preoccupied with their concerns and are consequently feeling anxious cannot hear and process the information they are being given, even where the information is relevant.

Why acknowledge all?

The mere expression of a concern is of itself therapeutic. Verbally acknowledging the patient’s concerns allow them to feel heard, respected.

Acknowledging the patient’s emotions brings down their level of anxiety and supports cognitive processing.

New information may raise new concerns; hence, the importance of checking for and acknowledging new concerns before giving more information.

Won’t it take longer?

Well actually no! This is because the patient’s agenda is established more quickly therefore, they are more able to process information given and better equipped to share decision-making. It also helps prevent those “doorknob disclosures”.

For further advice and training in effective, compassionate communication please contact the Maguire Communication Skills Training Unit the-christie.maguire.unit@nhs.net

Find out more:

  • Read evidence underpinning patient-centred interview structure here
  • Silverman, J., Kurtz, S., and Draper, J. (2013) Skills for Communicating with Patients. 3rd edn. Florida: CRC Press.
  • Learn more about the Maguire Communication Skills Training Unit here

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