ABSTRACT
General practitioners (GPs) probably perceive that time is the most significant external pressure inhibiting their work with patients. This chapter considers some other common factors which predispose to overdefensive behaviour. Doctors and other health professionals can modify their coping mechanisms so as to lead to a better outcome for the patient without causing too much pain for the doctor. There are numerous factors which can affect the consultation. In this case time was an important factor but perhaps not the major problem. It was, as the presenting doctor said, 'the whole context'. The chapter discusses an example of dumping syndrome and explains how irritated the doctor feel if a patient seems to be 'dumped' on them. Many other situations can predispose to defensive behaviour. General practitioners are expected more and more to engage in activities such as clinical governance or membership of a primary care group (PCG) which take them away from their patients.
