Doctors and the chronic pelvic pain patient.

Many women with chronic pelvic pain (CPP) turn out not to have any identifiable pathology despite having undergone multiple investigations. There is no consensus as to the best management for women in this group. Although a multidisciplinary approach to diagnosis and care has been advocated as best practice, it is costly and not practical in most units in the United Kingdom, and many other countries. Clinicians need to be aware of the importance of attitude and medical consultation as factors influencing patients' outcome from investigation and treatment. While consulting styles reflect the individual personality of the doctor, we need to be aware of our own underlying attitudes and how these might enter into the dynamics of the consultation. Some patients may want to have open, non-directive consultations, some more directive consultation styles. It is, therefore, essential for the physicians to identify patients' expectations or preferences and then try to meet them, in order to attain "concordance" in communication. In this chapter, we will examine some studies that relate to the doctor-patient relationship in women with CPP.