1. Anatomy and Physiology of Global Health Consultations Structure and Function Warren Heffron MD

2. 2 Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. [list all presenters and authors ] have indicated they have no relevant financial relationships to disclose.

3. Warren Heffron MD Professor Emeritus University of New Mexico. Albuquerque In His Image Residency. Tulsa (visiting faculty) 3

4. Initial Contact Promotion / Advertising Personal contact Commercial agencies Governmental agencies Non governmental agencies (NGO’S) WHO, WONCA, AAFP, MOH Grant catalogues 4

5. Pre Consultation Get to know your key contacts Program Director, Chair, Dean Set up schedule / time table Leave some free “thinking” time Consider multiple consultants Consultant trainee 5

6. Pre Consultation Planning What do they want / expect? Contract Payment, honorarium, travel expenses Information about the country, history, language, culture, geography, government Medical education, and service delivery 6

7. Pre Planning Set up those to meet with Those responsible for the program, all levels Leadership, administration Those fiscally responsible Supporters Those antagonistic to the program Credentialing, or certification agencies 7

8. Preplanning Expect surprises, add ons. Learn important issues about the country. Culture, history, geography, government, medical environment, medical education, religions, map of country, economy 8

9. Getting there Travel logistics Tickets Visa Lodging Costs Who will meet you Local transportation 9

10. Getting There Personal health issues Immunizations Chemoprophylaxis Water Adjustment time, jet lag Health insurance, evacuation insurance Resources, external, ie WHO, your hosts 10

11. Getting There Local key contact phone numbers and e mail 11

12. The Consultation Match their goals and objectives with the persons to meet Allow time with each person proportionally to the information needed to gather Start slowly if jet lag is an issue Schedule some time between meetings Weigh advantages of meeting with small groups, ie residents, administrators, faculty 12

13. The Consultation Template vs. no template Have a host with you Group meetings around meals Guard you evenings, avoid schedules from 8 AM to 10 PM. Keep time to review findings of the day and record, start outline of your consultation Plan thoughts for the next day 13

14. The Consultation Negotiate carefully other activities such as lectures and teaching while there. 14

15. Oral Check Out Provide an oral check out report Adequate unrushed time for discussion Include the key persons Include your main findings and recommendations. Consider sandwich approach.(Snapshot of your final report) Test for any misunderstandings Invite follow up relationships 15

16. Check Out Explore plans for use of the consultation Ask if there are things they desire you to include. 16

17. Formal Written Report Program, location, dates Consultant or team. Key leaders of the program. Brief background of program and reasons for the consultation. Main Body of Consultation Organize by problems or issues which led to the consultation request. 17

18. Written Consultation Identify individual issue. Discussion of problems and rationale around the issue. Recommendations. Summary of recommendations Overall summary Thanks to hosts, invitation to follow up. 18

19. Follow Up Written follow up evaluation ( a six months) Ongoing dialog / advice ( e mail ) Continuity consultations 19

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