Comment on On opening the clinical encounter by John Launer.

Thanks for this lovely and informative blog post Chris, and for mentioning my work and the summer course. The only other possible opening I want to add is one attributed to the Norwegian psychiatrist and family therapist Tom Andersen: “How did it come about that we find ourselves meeting here today?” It sounds a bit precious (and no doubt works better in Norwegian!) but a question of this kind sometimes does elicit very surprising answers like “I haven’t a clue: my surgeon recommended it but never explained why.” Having said that, I suspect the best approach is to try and match one’s opening spontaneously to first impressions of the patient and the emotional tone in the room, and then to be prepared to re-calibrate the next question if the response suggests that something different would have been better.