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Table 1 Overview of the different themes and quotes by GPs that relate to the different themes

From: Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study

GP reported difficulty

Quote

Being more person-centred

GP: Well, it’s a bit paternalistic too. I mean, I explain how things work and how things are. But when I look back at it now, I do feel it’s a bit schoolmasterly. I: What could you have done differently? GP: Well, I could have done it more in the form of questions, because it’s debatable whether that’s how she perceives it. (GP 5)

GP: Because she herself said, “Oh, these stomach pains, I want to do something about them.” At that point I could have asked, “What do you want to do? How do you feel about that?” Now I make a proposal, but of course she has to be OK with that. (GP 19)

Structure of the consultation

GP: Right, I realise I could have summarised things. And I could have been more explicit about the stages, saying OK, this is the moment to ask questions and then I’ll be doing the physical examination. I would have preferred it if I’d been clearer about that. (GP 10)

GP: I’d have preferred to do that the other way round: first give the summary, then the conclusion, then the course of action. Now everything’s a bit mixed together so that makes it rather chaotic. I find that messy. (GP 16)

A thorough psychosocial exploration

I: What could you have done differently? GP: I could have spent a bit more time on the anxiety and emotions because now those aspects haven’t really been discussed fully. (GP 1)

GP: I feel I didn’t ask her enough about why she’s so worried about the nausea. (GP 4)