Problem solving

 

Back in 1972 the RCGP proposed a consultation model, which became known as the Problem Solving model. It suggested that in a consultation a patient’s problem should be addressed with attention to physical, psychological and social aspects, and that for each aspect the problem should be presented, examined and defined, and then a solution should be proposed, examined and defined.

Although we don’t use this consultation model much now, it does give us some useful pointers when thinking about problem solving generally. After extensive research, I have come up with a list of Rules for becoming a successful problem solver. Here they are:

 

The problem

1. Firstly, be clear about what exactly constitutes the problem: there’s nothing worse than someone diving in and proposing solutions when they haven’t listened and grasped what the real problem is. 

2. Think laterally – try looking at the problem from every different angle

3. Think positively – the very word “problem” has lots of negative connotations, and negative thinking can hinder the whole process of problems solving; it helps if you can consider problems as an opportunity for making changes. Tackle negative thinking – recognise it, deal with it

4. Reduce large problems to a series of smaller problems – this tends to reduce the element of anxiety (or panic!), which hinders problem solving. With patients we can do this by getting them to draw up a problem list, which we can then prioritise.

5. Be honest – be aware of what the underlying problem is (even if you can’t see a way of changing it) rather than concentrating on the symptoms

 

The setting

6. Look at other areas (other than the problem in question) that you have been thinking about changing, or that will be changing anyway – this may reveal patterns, and ways of solving things

 

The solution

7. Don’t reinvent the wheel! How do other people deal with this problem? Would this work for you? If not, why not? (Watch out for negative thinking!)

8. Be creative – try to think of lots of different solutions, however impossible! If you can’t see any solutions, then it may be because you are unclear about what you are trying to achieve, or because you are unwilling to accept the right solution. Resistance to change may prevent you considering the best solution

9. Be adventurous – where do you really want to get to? – there’s nothing worse than putting a lot of effort into making a change only to find that it doesn’t get you far enough

 

When evaluating the possible solutions:

1. Propose a solution

2. Examine a solution

• What are the costs?
• What are the benefits?
• What do other people do?
• Whose time will it take to run it?
• Who will design it/work it out?
• What would happen if we did nothing?
• Are there any other alternatives?
• Is it worth it?

3. Choose solution

4. Put it into action

 

For the groupwork session this week, it would be helpful if you could bring along a tricky “problem” which you are prepared to discuss – it could be either medical or not, one of your own problems, one that has been discussed at a practice meeting, or a problem that a patient has presented to you.

 

Written by:   Martyn

Last update: 29 August 2007