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Video: Patient-Focused Encounter Framework

The GOTOIT framework, one of the core tools in Functional Medicine, is designed to center the patient during every encounter and to provide a structure for long-term follow up. This tool and how to use it are covered in IFM’s foundational course, Applying Functional Medicine in Clinical Practice (AFMCP). Shared decision making between clinician and patient has justifiably received much attention in published literature in the last decade, and one essential element is to focus on the person receiving care rather than the encounter itself.1 Researchers have suggested that clinicians use social norms and prompts to engage patients in their care, since patient engagement is known to improve health outcomes.2 GOTOIT is one such framework for that process, centering the patient and providing strategies and structure for clinicians across the patient journey.

In the video below, Jill Valerius, MD, an IFM certified practitioner, briefly describes GOTOIT and her favorite component: Tell.

Jill Valerius practices family medicine in Palmer, Alaska. She is also a certified athletic trainer and an avid bicyclist.

TRANSCRIPT:

We have a mnemonic that we use in Functional Medicine, and it’s called GOTOIT.

Probably one of the primary things that I love most about it—G is Gather, O is to Organize things, which is where we use our timeline and our matrix, T is to Tell.

Then we go on to Ordering, Initiating, and Tracking therapy.

One of the most valuable parts of that for me is the Tell component. What that involves is taking in someone’s story, processing what they’re telling you, and then retelling that story to someone. In that process, I can say to a patient, “This is what I hear you telling me.”

I can go on to tell them the story they just told me, allowing for corrections, and they can help me edit that.

References

  1. Clayman ML, Gulbrandsen P, Morris MA. A patient in the clinic; a person in the world. Why shared decision making needs to center on the person rather than the medical encounter. Patient Educ Couns. 2017;100(3):600-604. doi:1016/j.pec.2016.10.016
  2. Blumenthal-Barby JS. ‘That’s the doctor’s job’: Overcoming patient reluctance to be involved in medical decision making. Patient Educ Couns. 2017;100(1):14-17. doi:1016/j.pec.2016.07.010

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