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18, June, 2015

Dr. Maribel Cruz | The Five Star Doctor

preventive, or rehabilitive will be dispensed in
ways that are complementary, integrated, and
continuous

SESSION OBJECTIVES

To explain the WHO-DOH Five Star Doctor

Concept
To describe the professional roles and aptitudes of a
five-star doctor
CONCEPT OF A FIVE-STAR DOCTOR

An ideal profile of a doctor possessing a mix of

aptitudes to carry out the range of services that
health settings must deliver to meet the
requirements
of
relevance,
quality,
cost
effectiveness and equity in health.

DEFINITION OF TERMS
Relevance
- The degree to which most important problems
are
tackled
* Universal relevance
- universal access to health
- give help first to those who suffer the
most
- use local resources

Quality
- Use of evidenced-based data & appropriate
technology
to delivercomprehensive health care to
individuals and populations, taking into account their
social, cultural, and
consumer expectations

Cost-effectiveness
- Those that have the greatest positive impact
on the health of a society while making the best use
of its
resources

Equity
- Striving toward making high-quality care
available to all - Peoples needs, rather than social
privileges, guide the
distribution of opportunities for
well being

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5.

ROLES OF A FIVE-STAR DOCTOR

Health Care Provider
Communicator/ Educator
Researcher/ Lifelong Learner
Manager/ Administrator
Community Leader/ Social Mobilizer

1. Health Care Provider

Takes into account the TOTAL (physical, mental, &
social) needs of the patient
Ensures that full range of treatment curative,
Transcribers: Agra, Cueto, Pinon, Sy, Verin

Ensures that treatment is of highest quality

Considers the patient as an integral part of a family
and community
Ability to cultivate a good doctor & patient
relationship
considering
the
various
ethical
principles
Able to cultivate good-doctor colleague & allied
professions in order to give the best care to his
patients
Skills of Health Care Provider
Communication skills
History-taking
Physical examination
Clinical & Diagnostic Reasoning
Prescription Writing
Doctor-Patient Relationship
Assessing families
Preparing health care plan & health promotion
2. Communicator/ Educator

Doctors
of
tomorrow
must
be
excellent
communicators in order to persuade individuals,
families, and communities in their change to adopt
healthy lifestyle and become partners in the health
effort.

Able to promote healthy lifestyle by emphatic

explanation, empowering individuals & groups to
enhance and protect their health.

Skills of a Health Educator

Establish rapport with people
Assess the patients beliefs & perception
about the illness
Actively involve the patient & family in the
decision making process
Use language understood by the patient and
his family
Facilitate learning through a variety of
methods
Enlist the reinforcement of social support
Evaluate change & give feedback

Active Listening Skills

a. Attending
- Paying attention to the need of our patients
to be understood and cared for emotionally
- Involves the use of our bodies to
communicate the nonverbal message that Im
listening to you and I understand where you are
coming from
- L.O.V.E.R.S.
Leaning forward
Open stance
Voice of Compassion
Eye contact

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FAMILY & COMMUNITY MEDICINE

Dr. Cynthia Nacpil | Health, Disease and Normality

Relaxed position
Sitting at an angle

b. Bracketing
- Temporarily set aside our own feelings,
thoughts, and judgments
- Make space in our hearts and minds for
what the patient is really saying
c.

E
E
E
E
E
E
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E
E

Leading
c.1. Indirect Lead
- Opening invitations made by the
doctorcounselor for the patient
to talk about anything
he desires/
wishes
- Allows patient to go wherever he
chooses, with the encouragement of the doctorcounselor
-Appropriate question:
What would you like to talk
about?
What can I do for you?
- Do not say:
What is your problem?
This may come off as too
threatening
- Use forms of words or phrases:
Yes, Go on, And then, Uh-hmm
E
E

E
E
E
E

c.2. Direct Lead

- The doctor counselor
makes a judgment call as
to
where
the patient should go and asks the
patient to go to that direction
- Picking up from what the
patient has already
brought out into
the open. Do not introduce new
material
- non-directive
ex. tell me what bothered
you when you saw his dead face
Guidelines in making judgment as to lead
conversation:

note wherever the feeling is greatest

or most intense

pay attention to what the patient has

set aside

d. Reflecting
content,
feeling
and
experience
- The patient who is emotionally burdened
is unable to see
himself or his situation
clearly
- Acting as a mirror to reflect the patient
and his situation
so that the patient can see
himself and his situation more clearly and thus
take the most appropriate action to
change his
situation.
- Takes the verbal content of what the
patient says by paraphrasing it so as to make it
Transcribers: Agra, Cueto, Pinon, Sy, Verin

clearer
d.1. Reflecting content
Paraphrasing gets the essential
content of the patients message
and restates it in a more
summarized
and
organized
manner.
Perception check - in interrogative
form, reorients the doctor if the he
was mistaken, gives the patient
the chance to reexplain himself in
a clearer manner
d.2. Reflecting feeling
- Doctor-counselor articulates the
feelings of the
patient by making
an observation
ex. You seem to be quite anxious
about your
sore throat
d.3. Reflecting Experience
- Reflecting the non-verbal cues to
the patient
ex. I noticed that your lips
quivered when I
talked
about blood

e. Focusing
The
doctor-counselor
stirs
the
conversation into the topic
that is relevant to
the patients concern
ex. "This point seems worth looking at
more closely."
"You said something earlier that I want you
to go back to.
f.

Probing
- The doctor-counselor asks questions that
can elicit more information from the patient.
- Should be open-ended and NOT
answerable by a yes or no.
Ex. Looking back, what would you do
differently now, if
anything?
Compare this to what others have done.
What did your supervisor say /
do?
What was the
outcome?
Why did you do that?
3. Researcher/ Lifelong Learner

Research is important in the delivery of health

care services even in the primary care level

Chooses which technology to apply ethically &

cost effectively while enhancing the care that
he or she provides

Uses evidence-based medicine in the practice

of the profession

Has the responsibility to add the body of

knowledge so that more effective level

Able to critically appraise literature to be able

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FAMILY & COMMUNITY MEDICINE

Dr. Cynthia Nacpil | Health, Disease and Normality

to make good decisions in terms of
treatment and management

4. Manager / Administrator

Manages a clinic, hospital, community health

programs & projects

Can work harmoniously with individuals &

organizations within & outside the health care
system, in order to meet his/her patients &
community needs

Coordinate health care of patients & their

families with other physicians & agencies
through referral, networking, & linkages

Skills of Manager/Administrator
The referral system
Community organizing & management
Resource
generation
&
financial
management
Health policies & legislation

Transcribers: Agra, Cueto, Pinon, Sy, Verin

5. Community Leader/ Social Mobilizer

Does not simply treat individuals who seek help

but will also take a positive interest in
community health activities, which will benefit
large numbers of people

Who, after having won the trust of the people

among whom he/she works with, can reconcile
individual & community requirements and
initiate action in behalf of the community

The core of primary health care is people

empowerment

A physician has the task to change specific

behavior of patients & their families or
members of the community to achieve a goal

A physician plays a catalyst in accelerating &

sustaining program implementation through
active and collective participation of GOs and
NGOs in the community

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