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Table 3 Overview of the four GP discourses on consultation identified

From: What makes up good consultations? A qualitative study of GPs’ discourses

  Themes Preferred problems Difficulties
Biomedically-centered discourse - Executing guidelines - Medically ‘interesting’ problems - Lack of knowledge or expertise
- Scientific interest
- Referring patients to specialists - Problems that can be framed biomedically - Making bad impression to specialists
  - Medical expertise   
Communication-focused discourse - Decoding messages and signs - Problems with deeper psychosocial ground - Not being able to decode messages
  - Verbalizing thoughts and emotions   - Patient not open to communication
Problem-solving discourse - Pragmatic solution seeking - Clear-cut questions or problems for which the GP can provide a satisfying solution - Stress of finding solutions for problems
- Advising patients
- Convincing patients - Finding right balance in advising and convincing
  - Time management   
Satisfaction-oriented discourse - Satisfying your patients - Nature of problem of minor importance; satisfaction and patient’s expectations rule - Angry, dissatisfied, demanding or intimidating patients
- Economic thinking
- Positive rapport  
    - Patient’s lack of trust