Family Practice Vol. 17, No. 3, 277-278
© Oxford University Press 2000
Book Reviews |
Understanding the consultation: evidence theory and practice.
GP and VTS Course Organizer, Cambridgeshire, UK
The author's aim is to "describe a variety of ways of understanding the consultation" and "draw out the practical implications of these points of view". The book is "not an introduction to interpersonal communication skills". The 10 chapters do indeed look at different aspects of the consultation with a particular emphasis on the emotional aspects of care. Each chapter presents a succinct account of the area in question illustrated with case material. The chapters set out the evidence on which the account is based and make suggestions for an approach GPs might use. For example, Chapter 2, ‘Information sharing in the consultation', is very much based on the principles set out by Pendleton and colleagues, while Chapter 4, ‘Psychodynamic insights', reviews the contribution of psychoanalysis and the work of the Balints in understanding the consultation. I particularly liked Chapter 9, which is about somatization.
The book packs in a lot of material into a short space and I found it easy to read. This is perhaps because, as an experienced GP, I was fairly familiar with the content of the book. I found the book a useful summary of what I should be doing, though whether reading it will actually help me practise better is uncertain. I suspect that GP registrars will find it a harder read. For them, the book may well help them to pass their examinations but it probably will not make them into better doctors.
The book is clear, honest and covers a lot of ground. However, it lacks the charisma of a book such as Neighbour's Inner Consultation. At the same time, it avoids the overwhelming detail of Skills for Communicating with Patients by Silverman and colleagues. So enjoy the book for what it is, but, clearly, learning how to consult better is a practical and experiential process (for which, I should hasten to add, Silverman and colleagues are inspiring teachers).
My one irritation with the book is the change in the presumed gender of doctors and patients with each chapter, regardless of the gender of the patients used in the examples. There has to be a less stilted way of avoiding offence to readers of the ‘wrong’ gender.
Notes
Tim Usherwood. (150 pages, paperback £14.99, hardback £45.) Open University Press, 1999. ISBN paperback 0-335-19998-4, hardback 0-335-19999-2.
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