ABSTRACT
If a doctor has practised the various skills, then he/she will have found that most of the problems that were associated with closing have all but disappeared. Usually problems at the end follow inadequate agenda setting and exploration in the earlier stages, and failing both to elicit beliefs and expectations about the patient's current illness and to explain what is happening in the words that fit their framework. The elegant breaking of rapport that allows the doctor to disengage, take stock, regroup, look after themself and move on to the next patient in line. Patients cannot hear the unspoken thoughts, failure to address what might happen instead could leave people looking foolish. It's quite possible to say the words of farewell yet keep the same voice speed and tonality, matching and mirroring the patient's body language.
