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Consultation Skills

Negotiating and Persuading





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Why negotiation or persuasion?

Of course we want patients to make decisions for themselves.  But in many instances, we want to influence that decision because we can see the bigger picture that patients sometimes find difficult to see.   So, some of you might think that negotiation or persuasion isn’t particularly a person-centred skills, but I would argue that it is.   You as a GP will priveledged to information that the patient won’t know.  You can see the ups and downs of something as a result of your experience or training.  Sometimes it is difficult to convey that picture.   But you want to influence the patient because you know in your heart that it’s the best way forwards for them.   And by doing what’s best for them, is being person-centred!

For example, I had a patient who was in her 30’s and put on fentanyl patches for her back pain.    I knew in my heart that the long term outlook for her is not good – she will get addicted, the pain will seem more and more, and her whole life will be ruined by age 50 from the dampening and dulling effects of fentanyl.  She came in for a higher dose of fentanyl, but I knew that this was not the answer.  So we had a good discussion and we came to the agreement (through negotiation), that for the next month, I would keep her tablets the way they are, and for the following month for her to come in for a deeper discussion having given her some stuff to read and mull over about opioids.   When she came back, she said she wanted to give it a try providing we developed a regime where she came off fentanyl very slowly.  And that’s what we did.   Can you see the elements of negotiation and persuasion in this scenario?

Negotiation involves coming to an agreement regarding a particular matter and one of the critical skills in this context is the ability to persuade or convince another. Persuasion skills are a key ingredient to a successful negotiation.  

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