Overview

This book is about the doctor-patient relationship. It is not about counselling per se but about certain counselling skills intrinsic to the medical consultation or clinical transaction. Together with other clinical skills, intrinsic counselling skills are needed to achieve clinical goals, satisfactory to both patient and doctor and appropriate to the clinical transaction and to the wider systems of healthcare. Clinical transactions can be intellectually, emotionally and sometimes physically demanding. Success depends on doctor and patient adequately fulfilling the obligations and responsibilities of their respective roles. But evidence shows that success also depends on doctors and patients forming a personal relationship of a quality capable of sustaining the sometimes arduous and distressing clinical work. Such a relationship depends on good communication, adequate mutual trust and the ability of doctors to empathise sufficiently with patients and their predicaments. Intrinsic counselling skills are those deployed in the essential task of harmonizing professional and interpersonal aspects of the clinical action.

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