ABSTRACT
It's a chastening thought that, for every patient in the United Kingdom who presents a health problem to a general practitioner, about nine other people turn for advice on minor illness to retail pharmacists. As the consultation progresses, the initiative gradually shifts from patient to doctor. A diagnosis is a model. It's only worth having as long as it's useful. This chapter discusses management plans, whose formulation is in two stages, on different time scales. The first is to consider, 'what am I going to do right now, during this consultation?' This involves deciding immediate priorities, meeting your own and the patient's most pressing needs. The second thing to be clear about is, 'what is the plan after the patient leaves the room?' This second phase involves thinking of follow-up arrangements, referral, routine surveillance, managing the course of the problem on a longer time-scale.
