TY - JOUR T1 - The beleaguered consultation JF - British Journal of General Practice JO - Br J Gen Pract SP - 226 LP - 229 VL - 56 IS - 524 AU - Peter Davies Y1 - 2006/03/01 UR - http://bjgp.org/content/56/524/226.abstract N2 - The consultation is the central event in medicine at which the hopes fears and expectations of the patient meet the knowledge, skills and attitudes of the physician. From this event emerge the prescriptions, and treatment plans that healthcare systems struggle to afford. Performed well the collaboration in the consultation is one of the purest examples of the second commandment in action, to love our neighbour as we love ourselves. Performed badly the consultation can be a venue for rejection, misery and complaint.The central importance of the consultation was well described in The Future General Practitioner.1 This book has set the frame for general practice learning and teaching for the past 33 years. Its recommendations have directly led to modern medical standards such as summative assessment and ‘Good Medical Practice’.2–4The positive side of the consultation has been celebrated by many authors.5–8 The celebration is of the combination of professional skill with compassion unfolding into a long-term continuing relationship between doctor and patient.9–11 The achievement of this relationship is seen as the embodiment of the aspiration of the college motto, Cum scientia caritas (knowledge with compassion).In this essay I want to acknowledge this work and its achievements. I want to thank my trainers for making me think about my consultation style and therefore helping me improve it. I would love to spend the rest of my career enacting the skills I have acquired.However, although I recognise this I need to say that I find the conditions in which I practise do not allow me to fully deploy my abilities. I have a grief that there are forces arising that threaten to damage the practice of medicine. If unchecked they will nullify the great professional drive to practise … ER -