TY - JOUR T1 - Finding meaning in the consultation: introducing the hermeneutic window JF - British Journal of General Practice JO - Br J Gen Pract SP - 502 LP - 503 DO - 10.3399/bjgp20X712865 VL - 70 IS - 699 AU - Rupal Shah AU - Robert Clarke AU - Sanjiv Ahluwalia AU - John Launer Y1 - 2020/10/01 UR - http://bjgp.org/content/70/699/502.abstract N2 - The ability to offer individualised care to patients remains a key component of general practice. This is more important now than ever, given that the care we provide as GPs is likely to involve less face-to-face contact even once the threat of COVID-19 has passed. Many consultation frameworks address only generic skills and largely ignore the extent to which the clinician is able to establish a human connection, to understand what an illness means to their patient and to help them navigate through it, particularly when there is uncertainty and complexity within the consultation. This person-centred approach is the bedrock upon which general practice was founded and deserves further analysis. In this article, we introduce a new four-domain model to describe the skills and approaches needed by clinicians in order to encourage consultations that are individualised and create meaning for both patient and clinician. This model could help to guide training, as well as validating these consultation skills for practising clinicians.Iona Heath reminds us that ‘clinicians must see and hear each patient in the fullness of his or her humanity in order to minimise fear, to locate hope (however limited), to explain symptoms and diagnoses in language that makes sense to the particular patient, to witness courage and endurance, and to accompany suffering’.1In an interview recorded before his death in 2011,2 Dr Kieran Sweeney, a retired GP and Professor of Primary Care, poignantly described what was missing in the outwardly … ER -