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Table 3 Overview of the four GP discourses on consultation identified

From: What makes up good consultations? A qualitative study of GPs’ discourses

 

Themes

Preferred problems

Difficulties

Biomedically-centered discourse

- Executing guidelines

- Medically ‘interesting’ problems

- Lack of knowledge or expertise

- Scientific interest

- Referring patients to specialists

- Problems that can be framed biomedically

- Making bad impression to specialists

 

- Medical expertise

  

Communication-focused discourse

- Decoding messages and signs

- Problems with deeper psychosocial ground

- Not being able to decode messages

 

- Verbalizing thoughts and emotions

 

- Patient not open to communication

Problem-solving discourse

- Pragmatic solution seeking

- Clear-cut questions or problems for which the GP can provide a satisfying solution

- Stress of finding solutions for problems

- Advising patients

- Convincing patients

- Finding right balance in advising and convincing

 

- Time management

  

Satisfaction-oriented discourse

- Satisfying your patients

- Nature of problem of minor importance; satisfaction and patient’s expectations rule

- Angry, dissatisfied, demanding or intimidating patients

- Economic thinking

- Positive rapport

 
   

- Patient’s lack of trust