TY - JOUR T1 - Yesterday’s man? JF - British Journal of General Practice JO - Br J Gen Pract SP - 456 LP - 457 DO - 10.3399/bjgp19X705401 VL - 69 IS - 686 AU - Roger Neighbour Y1 - 2019/09/01 UR - http://bjgp.org/content/69/686/456.abstract N2 - I’m yesterday’s man. It’s now 15 years since I last saw a patient, and over 30 since my book The Inner Consultation1 first appeared. I’ve never consulted by smartphone, or Skype, or even by email. Granted, lots of trainees, trainers, MRCGP candidates, and coalface GPs continue to invite me to ride my hobby-horses in retirement and talk to them about consulting and the doctor–patient relationship. Indeed, in Sweden, where things are a little more leisurely, I’m still today’s man. And in Japan, where family medicine is in its infancy, I might even be tomorrow’s. But in the UK, where GPs are desperate for time and overwhelmed by demand, and the QOF has them by the throat, I suppose I’m a dinosaur. Passé. Yesterday’s man.Just for old times’ sake, though, indulge me; let’s think about the consultation. At its simplest, in process terms, only two things need to happen when a doctor sees a patient. You work out what the problem is, and then you agree what’s to be done about it. The important thing is to do them in that order, problem before solution. Most of the time, given today’s superabundance of advice, guidelines, and protocols, deciding what to do isn’t the hard part. The hard part is first making sure you’ve identified the right problem, the problem that really needs addressing, which is not necessarily the one that’s obvious, or easy, or convenient, or state approved.The pressures on traditional ways of consulting are only too familiar: rising workload and expectations; lack of time and resources; information overload; technological hyperinflation. And there is no shortage of suggestions for how to deal … ER -