Many doctors fear that adopting the counselling mode will encourage patients to waffle on indefinitely and they will never get home. This fear appears to be misplaced. Considering the importance of ascertaining the reason for the consultation, it is vital to give the patient a fair hearing. Wilkinson (1989) found that three-quarters of general practice patients had finished speaking within one minute and 98% had finished within two minutes.

The other aspect of time and the consultation is that it may take place over long periods as a succession of brief contacts. Analysis of one particular contact might reveal the absence of several critical phases. For example, negotiating a plan might well be omitted in subsequent contacts, once it has been agreed, if a contact is following up that particular problem only.

*335/197/1*

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