Challenging consultations

摘要

Atypical surgery in general practice will usually contain at least one consultation that does not go well, leaving doctor or patient, or both, feeling puzzled, dissatisfied or frustrated. And every GP will be able to name a few individuals whom they find so consistently debilitating as to be labelled 'heart-sink patients'. You know who they are: the 'Unrealistic expecters'; the 'Nothing ever works' or the 'While I'm here' brigade; the people with long lists or short fuses; the somatisers; the sufferers from medically inexplicable symptoms who nevertheless want endless investigations and referrals; those who have already consulted Dr Google. In this article I will try to tease out why it is that we find some patients difficult, and offer some suggestions for what we can do about it, (or at the very least make our consultations with them easier to bear).