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:
- Patient-Centred Approach
- Boundaries and Professionalism
- Medical error/Adverse events
- Breaking Bad News
- Resilience
Our distributed sites deliver the above core topics 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 Doctor – The 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)
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 (CBT) for anxiety, depression, stress management
Identification and Management of Common Behavioural and Psychiatric Issues: Anxiety, Depression, Addictions, Child Abuse and Neglect, Domestic Violence/Intimate Partner Violence, Pain Management, Post-Traumatic Stress Disorder, Grief Reactions, Relationship Issues, Difficult Conversations, LGBTQ2+ Care, 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
Advocacy and Health Promotion: (Resident/Physician Wellness and Resiliency, Indigenous Cultural Safety, Culturally Safe 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, Implicit Bias Training