What is it about the patient’s behaviour that you feel to be inappropriate? If your discomfort is around perceived unrealistic expectations by patients of you or the processes or services you provide, please see the ‘Managing expectations’ section.

When it appears that the patient wants to simply hand their problem to you, you are being drawn into a variant of the child-parent consultation model. It is important to always try and maintain an adult-adult interaction. As clinicians we need to help the patient understand that their health is our concern, but their task/responsibility. The aim should be for the patient to accept that their health is the result of their decisions and actions, and that the clinician is there to inform and support this process but not to take it over. Occasionally patients have a deeply ingrained external “locus of control” which can be difficult to change.

It is worth spending some time developing common boundaries for clinicians within the practice to observe in any consultation. What behaviour is appropriate, and what is not? Do we expect patients to call us by our professional names, and do we reciprocate by calling them Mr., Mrs., etc., or do we not? Do we agree that this is how we will all behave on all occasions, or are we willing to allow a degree of deviation? In order to be successful, the agreed ways of working should be observed and upheld, without deviation where possible. Patients are more likely to recognise boundaries if they are consistent across the organisation and, to this end, wider considerations for patient-staff interactions overall should also be set.

You might wish to consider the following:

• Practice Workload Philosophy