Book Review: Consulting in a Nutshell by Roger Neighbour.

Peter Aird is a GP in Bridgwater, Somerset.

“Who is Roger Neighbour?”

The answer to this question that has long been asked by those seeking to be seen to have acted well is, as many will already know, that Roger Neighbour is a retired GP, a former Convenor of the Panel of MRCGP Examiners and past President of RCGP, UK. He is also the author of a new guide to successful general practice consultations.

There will be those who ask whether we really need yet another book on how to consult well, especially from one who has already given us ‘The Inner Consultation’, a book that was required reading back when I was a fledgling GP. I confess to having been a little sceptical myself as I started to get into the book which, if I am honest, was, at first, a little hard to crack. But having got through the somewhat tough outer shell, inside was an easily digestible kernel of consultational truth that was most certainly worth the initial effort.

All the old favourites were there, from responding to cues and uncovering hidden agendas to exploring the patient’s ideas, concerns and expectations. But alongside these were some new techniques that I’d not come across before, including tips on ‘thinking aloud’ and ‘turning a receipt’, the latter an effective way of steering consultations in the directions they need to travel. Together they all combine to serve a simple and practical three part model which seeks to ease GPs though consultations which, Neighbour suggests, should begin with ‘the patient’s part’, continue with ‘the doctor’s part’, and then conclude with ‘the shared part’.

Consultations … should begin with ‘the patient’s part’, continue with ‘the doctor’s part’, and then conclude with ‘the shared part’.

The book will be especially helpful for those preparing for the CSA, and it contains plenty of neighbourly advice for that exam. But it will also prove useful to those who, though they may be tempted to imagine they don’t need to be taught how to suck eggs, may nonetheless have a sneaky feeling that they would once again like to experience those coddled ovoid delights that they have, perhaps, neglected for far too long. Indeed, after a year which has seen us all increase our levels of remote consulting (a subject that is addressed in the book), few will have avoided slipping into bad habits when it comes to how we consult. I suspect there will be many of us who could do with this timely reminder of how to consult well, and of the enormous satisfaction that can follow from having done so. I for one certainly benefited. As I read I sensed a desire rising within me to sharpen up my consulting skills and I even found myself subsequently trying out the book’s suggestions on my own patients.

But over and above …. we are to show kindness in our consultations.

But over and above all the excellent advice the book offers is the sense that comes across that we are to show kindness in our consultations. Neighbour takes pains to counsel against consultations that are formulaic and insensitive and urges us not to adopt a consulting the tick box mentality that is all too often encouraged elsewhere in medicine. Instead he wants us to use his model as a tool which encourages the application of the human touch in our interactions with our patients, a means of offering ‘cum scientia caritas’, the RCGP’s motto, and which he roughly translates as ‘kindness with competence’.

‘Who then is R. Neighbour?’ He is, in a nutshell, someone who has written a book that encourages us to consult with others in the way we would want others to consult with us. And that, by itself, is more than enough to justify my heartily recommending this book.

 Featured Book

Consulting in a Nutshell. Roger Neighbour. CRC Press; 1st edition. 2020. ISBN-13: 978-0367456955


Featured photo by Bermix Studio on Unsplash

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