So, telling cases from the four research projects were selected as examples of consultations that breach the clinician patient 'dyad', incorporating additional 'voices'voices
Dialogues from the consultation room are quoted in this article where they constitute typical examples of consultations either because of their short duration or because they represent a typical style of communication between health professionals and mothers.
Taking the example of consultation transcripts, the initial analysis involves taking aspects of the data and ascribing to them some sort of meaning – one might for instance devise a system for identifying different types of questioning by the practitioner: open, closed, hypothetical etc.
Two examples of incongruous consultation behaviours are: i) consultation with a GP for symptoms self-rated as low impact (designated here as "low impact consultations") and ii) no consultation with a GP for symptoms self-rated as high impact (designated here as "high impact non-consultations").
Some examples of this consultation subset included multiple opportunities to discuss AOD topics.
First examples of video consulting as allowing consultations with the GP or even email communication between patient and GP have been evaluated with positive results [ 13- 15].
These barriers have been overcome in some cohorts and in other fields, and these provide examples of how more consultation could be undertaken within the scope of funding and resources.
In this study we chose narrative analysis because we wanted to catch the dynamics of challenging encounters, in order to examine specific examples of how the consultation can go wrong.
The moderator used an approved topic guide, which covered the following topics: participants' views on the use of phones during consultation, examples of phone usage during the primary care consultation, as well as the experience of the patients and HCWs as a result of the interrupted primary care consultation.
Other less frequently reported barriers included feeling that the intervention might lead to use of a paternalistic (rather than shared decision-making) approach, and examples of slightly 'dysfunctional' consultations where the communication style was perceived to have led to a loss of patient-focus and/or the usual quality of rapport was disrupted.
