Consultation skills: a personal reflection on history-taking and assessment in aesthetics

Abstract

Aesthetic medicine is a rapidly developing specialty that many have a growing passion for and dedication to. Although not strictly defined by the Nursing and Midwifery Council (NMC) or General Medical Council (GMC) as a specialty, it should, in the author's opinion, be treated as such. This would suggest that every facet of aesthetic medicine stand on the four pillars of medical ethics: autonomy, beneficence, non-maleficence and justice. These have been described in the GMC's Good Medical Practice (2013) in four domains. Domain one describes knowledge, skills and performance, making the care of the patient a doctor's first concern. Domain two looks at safety and quality, urging doctors to ‘take prompt action’ if they think that patient safety, dignity or comfort is being compromised. Domain three describes how to work with patients and colleagues to reach decisions together about their treatments. Domain four is about maintaining trust by being open and honest with patients. The consultation is arguably the cornerstone of any practitioner–patient interaction. Consultations include taking a history, undertaking an examination, arriving at a diagnosis and formulating a treatment plan, while also taking into consideration a patient's ideas, concerns and expectations. Executed correctly, this will ensure the four domains of good medical practice are adhered to. The success of any consultation depends on how well the patient and practitioner communicate with each other. This article looks to focus on the consultation process in aesthetic medicine.