Thirty years ago Stott and Davies described a structure for the content and conduct of the general practice consultation. This consists of four interconnected topics and tasks -understanding and dealing with the acute, presenting problem, attending when appropriate to comorbidity and other chronic medical problems, incorporating health promotion and risk management and evaluating patients' use of health services and their own engagement with their medical problems. The themes of ideas, concerns, and expectations of the biopsychosocial model of illness, and of communication, diagnostic, and negotiating skills run throughout these tasks. Papers in this issue of the BJGP illuminate and build on this approach to patient care, which is given a welcome and interesting new dimension by Ian McKelvey, who describes The Consultation Hill (page 538), a persuasive account of a model to aid the teaching of consultation skills.
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