Mutual understanding: a communication model for general practice

Objective - To present our pursuits towards development of a simple model for clinical communication intended for application by the practitioner as a tool for enhancing mutual understanding. Design - Inspired by theories about patient-centredness and interactive modes of understanding, and supported by the perspectives of the Danish philosophe r Niels Thomassen, we reviewed audiotapes from our own consultations. Recognising four dimensions assumed to be essential for mutual understanding in the transcripts, we explored these dimensions further. Results - We present a communication model consisting of the following dimensions: The Framework, within which the communication takes place; The Subject, about which the communication takes place; The Persons, between whom the communication takes place; and The Action, verbally and non-verbally, through which communication takes place. We describe these dimensions in detail. The nature of the dimensions indicates that there is an interrelationship between them, implying that the character of the communication may change if one of the factors is changed. Conclusion - Analysis of an ongoing or recent consultation completed in accordance with these four dimensions allows the doctor to refocus the communication, thus leading to a more extensive mutual understanding and perhaps enhanced freedom of action.