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Conflict in General Practice.
  1. R K Mckinley
  1. Department of General Practice & Primary Health Care, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK

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    L A Hobden-Clarke, S A T Law. (Pp 208; £17.50). London: Royal Society of Medicine, 1997. ISBN 0 443 05936 5

    The authors of this book promise much. They rightly identify conflict as being common and frequently corrosive, but they are careful to emphasise that conflict can also be constructive and should not necessarily be feared. The authors describe how pervasive conflict is, and how protean its manifestations are, but reassure us by emphasising that many of the skills required for the resolution of conflict are possessed by general practitioners and good managers—namely, communication and problem solving skills. The authors have constructed the book with more or less independent chapters, each dealing with a different “conflict zone” ranging from conflict with patients through to conflict with authority. The chapter on “conflict with partners” is probably the most valuable of these. The last three chapters on managing conflict, a series of case studies, and a summary and conclusions are particularly valuable.

    Unfortunately, writing the book as a series of independent chapters means that it is repetitive and the truisms that “poor communication feeds conflict” and “prevention is better than cure” are covered in many chapters. It also makes the book's principal weakness particularly apparent; it is already out of date. Fundholding is no longer an issue whereas current foci of conflict (primary care groups and trusts and the identification of poorly performing practitioners) are not covered. The otherwise useful chapter on “conflict with partners” is diminished by a peculiar table of the “signs” of poor physical or mental health which, by and large, are symptoms likely only to be recognised by the unwell person and therefore of scant use for detection by another.

    The authors accepted a considerable challenge by writing this book. They have provided some useful advice, some inappropriate advice, and some which is already out of date. This volume would be of most use if used as a focus for critical discussion rather than as a textbook or guideline for practice.