Behavioural Medicine

 

What is Behavioural Medicine?

Includes skills that are the “HeART of Family Medicine” (Dr. David Kuhl, 2005)

  • The “how we do what we do”
  • The “Therapeutic Alliance”
  • Focus on “Process” (rather than content)
  • The Patient-Centred Method
  • Understanding of Self in the Doctor-Patient Relationship

 

Behavioural Medicine involves an approach that provides a set of conceptual and behavioural tools that are especially relevant to the discipline of family medicine

 

Learning Objectives of Behavioural Medicine:

  • Patient-Centred Interviewing Skills
  • Verbal and Non-Verbal Communication Skills, Active Listening, Expression of Empathy, Unconditional Positive Regard
  • Balancing the Priorities of the Patient and the Physician
  • Establishing a Strong Doctor-Patient Relationship
  • Managing Difficult, Emotionally Intense Interactions
  • Becoming Aware of and Reflecting on the Impact of Your Personal Feelings (anger, frustration, transference, counter-transference) in Interactions with Others

 

Behavioural Medicine Curriculum:

There are 5 defined core curriculum topics that are delivered at each residency site as follows:

  1. Patient-Centred Approach
  2. Boundaries and Professionalism
  3. Medical error/Adverse events
  4. Breaking Bad News
  5. Resilience

Our distributed sites deliver these as well as additional topics of their choice from the general overview (see below) using shared and local resources augmented and enhanced by experiences in clinical settings. Delivery of curriculum to residents occurs during workshops, academic didactic/interactive sessions, exam preparation evenings, video review sessions and clinical exposures.

 

Being a DoctorThe Patient-Centred Approach/The Doctor-Patient Relationship/The Whole-Patient Perspective

Bioethics and Professionalism in Family Medicine – Principles of Medical Ethics (Beneficence/Maleficence, Fiduciary, Autonomy, Justice, Fidelity, Veracity) and Ethical DilemmasTopics: Advance Directives/Substitute Decision Maker, Boundaries, End-of-Life Issues, Consent (Capacity, Disclosure, Voluntariness), Truth-Telling, Conflict of Interest, Adverse Outcome/Medical Error, Confidentiality, MAID, Medical-legal Aspects of Practice, Patient Advocacy Involving Third Parties, Moral/Religious Conflicts Faced by Physicians

 

Behavioural Medicine Topics

  • Lifestyle Counselling: Smoking Cessation, Weight Loss, Exercise, Substance Use, Motivational Interviewing
  • Cognitive Behavioural Therapies for anxiety, depression, stress management.
  • Identification and Management of Common Behavioural and Psychiatric Issues:
  • Anxiety, Depression, Addictions, Child Abuse and Neglect, Domestic Violence/Spousal Assault, Pain Management,  Post-Traumatic Stress Disorder, Grief Reactions, Relationship Issues, Difficult Conversations,  LGBTQ2 Health, Gender Dysphoria, Eating Disorders, Sexual Assault/Abuse, Approach to the Suicidal Patient, Psychiatric Certification,  Childhood Behavioural Problems, Learning Disorders, Sexual Problems, Vicarious Trauma, Cognitive Impairment and Dementia
  • Special Interest Issues (Resident/Physician Wellness and Resiliency, Culturally Sensitive Care, Indigenous Health Care, Child Protection Issues, Driver Competency Issues, Periodic Health Assessment and Screening, Chronic Illness, Financial and Practice Management Strategies, Breaking Bad News,), Reflective Practice, Narrative Medicine, Mindfulness Training