INTRUDERS IN THE CONSULTATION

A confidential consultation is the essence of family practice. That co nfidentiality is currently under attack from a number of disruptive in fluences. Several of these are physical intruders: telephone calls, un dergraduate and postgraduate students, video recorders, computers, gui delines, protocols and health promotion activities. The potential bene fits of each of these is analysed to elucidate why they have been allo wed into consultations. Their drawbacks in the light of current publis hed evidence is presented. Conditions which make intrusions permissibl e are proposed and practical suggestions are made about how to minimis e their impact.