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'Get tough with heartsinks'

GPs need to be more firm with their heartsink patients, a group of leading GP academics claim.

In an article in next month's Family Practice, they argue GPs are left 'powerless' to deal with heartsinks because they are trained to view the doctor-patient relationship as paramount.

Author Dr Carolyn Chew-Graham, GP and senior lecturer at the University of Manchester, said it could be 'pos- itive' for GPs to pass a difficult patient to a colleague.

GPs should also enter into a verbal contract with heartsinks over what is to be discussed and end the consultation if it is broken, she added.

She said: 'The GP thinks they must keep the relationship going and that should be paramount. We are saying that it does not have to be that way.'

Inadequacies in current training for GPs in handling difficult patients added to the problem, she said.

Co-author Professor Martin Roland, director of the National Primary Care Research and Development Centre, said GPs felt 'frustrated and trapped' at having to collude with patients unwilling to recover from long-term illness.

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