Consultations may go wrong for a number of reasons:
- Assumptions - patients and doctors have different attitudes, beliefs, prejudices and expectations
- Detachment - a degree of detachment is necessary for making the diagnosis and managing the patient
- Anxiety - a high level of anxiety in the doctor increases inappropriate investigations and referrals
- Emotions - the doctor may feel uneasy with the patient's emotions or be unwilling to show emotion
- Frequent attendance - strategies have be found to limit some patients demands
- Dependence - unnecessary follow-up consultations and visits reduce the patient's autonomy
- Behavioural factors - the doctor may unwittingly do something that makes the patient feel very uncomfortable
- Environment - the way the surgery is set out may hinder a successful consultation
ref: P McAvoy, ch 5 of Clinical Method, A general practice approach, ed Robin Fraser, 2e 1992 K Hodgkin, Towards Earlier Diagnosis, A guide to primary care, 5e 1985