Introduction
In the field of advanced clinical practice, effective communication between clinicians and patients is paramount, particularly in oncology where emotional and psychological challenges often accompany complex medical decision-making. The Neighbour Model of Consultation, developed by Roger Neighbour in 1987, offers a structured framework for consultations that prioritises patient-centeredness and reflective practice. This essay explores why the Neighbour Model is a suitable approach for oncology clinicians, focusing on its emphasis on building rapport, ensuring safety, and facilitating shared decision-making. By examining these key aspects, supported by relevant literature, this discussion aims to highlight the model’s applicability to the sensitive and intricate nature of oncology care.
Building Rapport and Trust in Oncology Consultations
The first stage of the Neighbour Model, ‘connecting,’ underscores the importance of establishing rapport with patients. In oncology, where patients often experience fear and uncertainty about diagnoses such as cancer, building trust is essential for effective communication. The model encourages clinicians to actively listen and demonstrate empathy, creating a safe space for patients to express concerns. For instance, when discussing a new cancer diagnosis, an oncology clinician using this model might prioritise understanding the patient’s emotional state before delving into treatment options. Research suggests that empathetic communication enhances patient satisfaction and adherence to treatment plans (Stewart, 1995). Therefore, the Neighbour Model’s focus on connection aligns well with the emotional needs of oncology patients, fostering a therapeutic alliance that is critical in such high-stakes settings.
Ensuring Safety and Addressing Complex Needs
Another strength of the Neighbour Model lies in its ‘safety-netting’ stage, where clinicians ensure that potential risks are addressed and follow-up plans are clear. In oncology, where treatments often involve significant side effects and uncertainties (e.g., chemotherapy-related toxicities), this step is particularly relevant. Oncology clinicians must anticipate complications and provide patients with clear guidance on recognising deterioration or when to seek help. According to Levinson et al. (2013), structured safety-netting reduces miscommunication and improves patient outcomes in chronic disease management. By incorporating this principle, the Neighbour Model helps oncology clinicians mitigate risks, ensuring that patients are supported beyond the consultation room—crucially important in a field where vigilance is often life-saving.
Facilitating Shared Decision-Making
The Neighbour Model’s emphasis on ‘handing over’—where responsibility is shared with the patient—aligns with modern ideals of shared decision-making, a cornerstone of oncology practice. Cancer care often involves weighing complex treatment options, such as surgery versus radiotherapy, each with distinct risks and benefits. The model encourages clinicians to involve patients in these decisions, respecting their values and preferences. Indeed, studies indicate that shared decision-making improves patient autonomy and satisfaction in oncology settings (Kane et al., 2014). By promoting collaboration, the Neighbour Model ensures that oncology clinicians can tailor care to individual needs, enhancing both clinical and personal outcomes for patients.
Conclusion
In conclusion, the Neighbour Model of Consultation offers a robust framework for oncology clinicians by prioritising rapport, safety, and shared decision-making. Its structured yet flexible approach addresses the emotional and clinical complexities inherent in cancer care, as evidenced by its alignment with patient-centered principles supported in contemporary research. While the model is not without limitations—such as the need for time-intensive consultations—it remains a valuable tool for enhancing communication in oncology. The implications for advanced clinical practice are clear: adopting this model can improve patient experiences and outcomes, reinforcing the importance of empathetic, systematic consultation in such a challenging field.
References
- Kane, H.L., Halpern, M.T., Squiers, L.B., Treiman, K.A. and McCormack, L.A. (2014) Implementing and evaluating shared decision making in oncology practice. CA: A Cancer Journal for Clinicians, 64(6), pp. 377-388.
- Levinson, W., Lesser, C.S. and Epstein, R.M. (2013) Developing physician communication skills for patient-centered care. Health Affairs, 29(7), pp. 1310-1318.
- Stewart, M.A. (1995) Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal, 152(9), pp. 1423-1433.
