Foreword. Introduction. Before the patient enters the consultation. Inner consultation skills. Non-verbal and verbal consultation skills. EBM. Risk scores and guidelines: which ones and why. Accessibility within a consultation. Who writes them - conflicts of interest (gifts and sponsorship). Grey/ unpublished trials - Big Pharma and conflicts of interest. How to use them. Statistics in medicine with analysis examples. Statistics and interpretation - what is truth? Personal bias. Ethics in the consultation. Legislation. Consent. Capacity. Special cases: vulnerable adults and children. Carers and family members. Translators. Gifts. Sex, contraception and abortion. End of Life and DNR. Mental Capacity Act and best interests. Lasting Powers of Attorney (LPA). Advanced Directives (AD). Deprivation of Liberties (DOLs). Safeguarding Vulnerable Adults. Safe-guarding children. Benefits. Harms. Autonomy. Justice. Aristotle's Virtues. Doctor patient relationships. Chaperone. Treating family and friends. Cultural and religious influences. Duties of a Doctor. Record keeping (phone consultations benefits and pitfalls). Contextualising to the patient. Investigations. Management plans - non medical patient centred. Teams and communication within a practice and outside agencies. Communication, timing, replies. Prescribing. Polypharmacy. Multiple diagnoses with examples of potential problems and solutions. Patient views. Hurdles to patient accessing doctors. Patient influences i.e., journalism. Patient understanding and opinion forming. Long term adherence: factors for and against. Reaching an agreement and planning. Conclusion. Cases illustrating use of the outer consultation framework to enhance clinical decision making. Long term care and enjoyable careers.