Consultations: the Good, the Bad, and the Difficult
Models and Milestones
In the Beginning
Speaking the Patient's Language
Managing Feelings: Your Own and the Patient's
Getting Patients to Tell You What's Wrong
Summarising and Reflecting
Giving Information to Patients
Safety-Netting and Ending
Transactions in Consultations
You, the Patient, and the Computer
Looking After Yourself Tools and Techniques for Learning and Improving Consultation Skills
Knowing Where to Start and What to Learn
How Adults Learn
Working with Colleagues to Improve Your Consultation Skills
Getting and Giving Effective Feedback
Using Role Play to Help with Consultation Techniques
Consultation Skills and the RCGP
Making a Personal Learning Plan
Conclusion Appendix 1: Jargon Buster
Appendix 2: Some Useful Resources
Liz Moulton is a freelance general practitioner (GP) in West Yorkshire and a GP appraiser and advisor to the Royal College of General Practitioners (RCGP) Practice Support Unit. She graduated from Leeds University and was a GP registrar on the Airedale Training Scheme. She then worked in the Academic Primary Care teaching practice at the University of Dundee before settling in Yorkshire, working in two different GP training practices. Liz was a GP trainer for more than 20 years. She has been course organiser for the Leeds Vocational Training Scheme for general practice, served as associate and deputy director at Health Education Yorkshire and the Humber, worked in primary care development for Leeds Health Authority, and acted as a GP advisor to the UK Department of Health. Liz has also run many courses on consultation skills for GPs, GP registrars, nurses, and nurse practitioners, and was recently appointed to lead "The Consultation" and "Teaching the Consultation" modules for the University of Leeds' masters' level course for medical teachers. She was absolutely delighted to be awarded an MBE in 2005 for services to medicine and healthcare in Yorkshire.
"It offers a very clear summary of consultation skills theory
with lots of practical tips... This is a helpful and easy-to-read
using summaries and linking to the current RCGP CSA. It is very
helpful for GP trainees."
- (Highly Commended, Primary Health Care, BMA Medical Book Awards 2016)
"Our health service is facing unprecedented changes and the pace
of change seems to increase year on year. ... Still one thing
remains constant: the helping nature of the human contact between
clinician and patient that empowers the patient. This is the
subject of Liz's book, a book that I would advise those new to
general practice to read and those experienced in our art to
re-read. ... This book will, I believe, enable you to understand
your interactions with patients better and, amidst the
ever-changing context and environment, ensure you have the skills
you need for effective consultations."
-From the Foreword by Dr. Mark Purvis, Director of Postgraduate General Practice Education, Health Education Yorkshire and the Humber, University of Leeds, UK
Praise for the Previous Edition
"I am not much given to fan mail, but I feel compelled to let
you know that I am tearing my way through The Naked
Consultation and consider it the most practical and useful
work on the matter ever produced in the UK. It is some time since I
have read a book that has given me more than a single new
insight-yours has brought me a bucketfull. Thanks. Well done."
-Dr. Malcolm Thomas, Medical Director, Effective Professional Interactions, Ltd, Morpeth, UK
"This practical guide to consultation skills is written by a GP.
However, practice, specialist and consultant nurses will find that
its focus on consultation processes, skills and the use of
counselling will help them enhance their work with patients. There
is an excellent 'jargon buster' defining and describing a
comprehensive list of terms and a selection of useful document
templates. Many chapters are short, focusing attention on basic but
important skills. Excellent!"
"Liz Moulton-a GP and trainer-has come up with a practical
vade mecum for any doctors interested in buffing up their rusty
consulting skills, adding a few new tools to their consulting
toolkit, or even diagnosing what went wrong in their latest
consultation from hell. What I like about it is that it breaks the
consultation down into key phases that GPs will recognise (for
example, the beginning, getting patients to tell you what's wrong,
safety netting, and ending), and then draws on whichever models
might be relevant to that bit. This is a readable book with plenty
of case studies and action points to try. Unlike some books I've
reviewed, The Naked Consultation won't be filed in my
loft-it'll sit right next to the Oxford Handbook on my
"A must for anyone who wishes to improve their
consultation skills or aims to better understand the process of
making a cup of tea! Particularly good for the beginner (medical
student, ST1 registrar) or the time-pushed, as the author gives
clearly presented, readable summaries of the key theories in this
field. I am a clinical teaching fellow in primary care and
currently recommend this book to all our students."
"This charming book has a contemporary style which
sets it apart from other consultation books. This is a must read
for those aiming to pass the CSA exam comfortably. Its charm is in
its easy-to-read pages with chapters listed as buzz words that are
used in marking schemes for COT and CSA assessments. It consists of
two parts: 'Part 1: Deconstructing the Consultation' and 'Part 2:
Tools and Techniques for Learning and Improving Consultation
Skills,' with an appendix 'jargon buster' at the end. This book was
showcased by the recent RCGP Consultation Skills and Reducing Risk
Workshop, and with good reason, in my opinion."
-Dr. Shazia Mahmud, GP, Health Sciences Library, Frimley Park Hospital NHS Foundation Trust, UK
"A useful addition to the consultation literature.
The audience includes any type of primary health care practitioner,
and teachers and clinical trainers would also find this useful. The
author has addressed the intricacies of the consultation process
with an improvement focus that engages readers and keeps them
turning the pages."
-Doody Enterprises, Inc.
"Has a relevance to anyone who has an interest and involvement with practical and clinical patient assessment. It will also be a useful aid for lecturers and trainers who teach communication skills. A learned text that is also light and likeable."
-Cancer Care News
"[This] book is exactly what it says on the tin:
'a practical guide to consultation skills for any health
professional working in primary care.' ... In the first part of
this book, Liz Moulton presents in her own approachable style the
key features of most of the established consultation literature.
The second part, of as much interest to teachers and trainers as to
clinicians in training, reviews a wide array of current teaching
and learning methods. She covers PUNs and DENs, working with
colleagues, case discussion, role play, and video in eminently
practical ways. The Naked Consultation is a practical and
readable vade mecum for the would-be skilled consulter."
-From the Foreword to the First Edition by Roger Neighbour, MA, DSc, FRCP, FRCGP, Bedmond, UK