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Remembering ABCDE in general practice

I enjoyed reading Professor David Haslam's February column on mnemonics for general practice ‘Finding phrases that stick in your brain' (Practitioner 2008;252 [1703]:47).

Here is one I have developed for myself and for students. I try to use it for every consultation and it comes from 30 years of general practice experience.

A: be Agreeable, Approachable and Accepting. In other words, be nice to each patient. It is this they will remember afterwards and, above all, it makes them want to see you again.

B: never Beat yourself up over what is the Government's job and not yours. Sick notes, waiting lists... the list is endless.

C: practise Clinical medicine. A thorough history and examination is therapeutic for the patient and keeps you out of trouble.

D: Dance with the patient. This is a term used by counsellors and therapists, and is a casserole of open questioning, active listening, Socratic dialogue, CBT and empathy. It is a journey for the doctor and patient in which they are equals. ‘Dancing' is a very good term for it; a short dance with every patient (and sometimes a very long one) is mandatory before anything else.

E: Estimate the patient's satisfaction at the end of every consultation. Make sure they know what you think and why, ask yourself if you could do more and if they are happy so far, etc.

I, like every GP, have made my share of mistakes but always because I did not follow the rules above.

Dr David Hogg, GP

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