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Family Practice Vol. 21, No. 3, 229-231
Family Practice Vol. 21, No. 3 © Oxford University Press 2004, all rights reserved.

Editorial

The harmful consequences of elevating the doctor–patient relationship to be a primary goal of the general practice consultation

Carolyn A Chew-Graham, Carl R Maya and Martin O Rolandb

School of Primary Care, University of Manchester, Rusholme Health Centre, Walmer Street, Manchester M14 5NP, a Centre for Health Services Research, University of Newcastle upon Tyne and b National Primary Care Research and Development Centre, The University of Manchester, Williamson Building, Manchester, UK

E-mail: cchew@man.ac.uk

Received 6 May 2003; Revised 22 September 2003; Accepted 7 January 2004.

Chew-Graham CA, May CR and Roland MO. The harmful consequences of elevating the doctor–patient relationship to be a primary goal of the general practice consultation. Family Practice 2004; 21: 229–231.

Keywords. Consultation, doctor–patient relationship.

The first 10% of the full text of this article appears below.

Introduction

In the UK, it has been estimated that an ‘average’ GP will undertake ~8000 face to face clinical interactions annually.1 The consultation has come to be identified as the cornerstone of general practice,2 and to be seen more than an occasion for the medical work of diagnosis and treatment.3 Beginning with the work of Balint,4 it has also come to be seen as a ‘meeting’ of individuals in which (often undifferentiated) symptoms are expected to be understood and accommodated in relation to their social and psychological contexts. Much effort in education and research has been invested in giving the consultation this deeper meaning and wider range of potential practice.5 Thus, whilst the doctor–patient relationship is a given in today's primary care, achieving a satisfactory doctor–patient relationship has also been elevated to be an outcome or goal of every consultation. In many ways, exploring that . . . [Full Text of this Article]

Collusion and its contexts

Discussion

Conclusions

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