Reframing Our Attitude to MSK Consultations in Primary Care

Let’s face it—MSK consultations in primary care can be tough. From back-to-back appointments and diagnostic uncertainty to emotionally charged conversations and time pressure, it’s easy to feel overwhelmed. But amid the stress, we often forget the positive impact we’re making—sometimes just by being present and listening.

This blog explores the challenges of MSK consultations and reminds us why mindset matters—not just for patient care, but for our own wellbeing.

Why MSK Consults Can Feel So Draining

Most of us didn’t choose healthcare for the job title or the payslip. We chose it because we care about people. Yet even with the best intentions, the daily grind of primary care can wear us down.

You might be:

• Seeing over 20 patients a day

• Managing diagnostic pressure and prescribing demands

• Balancing documentation, safety-netting, and red flag awareness

• Supporting patients emotionally within a 10–20-minute slot
  

Sound familiar?

Those difficult consults—the ones that run over, involve tears or confrontation, and leave you emotionally depleted—can feel like a heavy weight. And as we rush to see the next patient, that burden can quietly accumulate.

The Power of Presence: What We Often Underestimate

But here’s the flip side.

Even during the most challenging consultations, we’re making a difference. Moulton (2016) describes how emotional energy transfers during the consultation—simply listening and showing empathy can help relieve the patient’s distress, even if the physical problem remains unresolved [1].

In that short appointment window, we can:

• Reassure someone who’s worried about a serious condition

• Empower a patient with knowledge and self-management tools

• Prevent unnecessary fear or investigations

• Improve quality of life, not just clinical symptoms

Shifting Our Mindset: “How Can I Help This Person Today?”

It’s easy to see a full clinic list as an uphill struggle. But shifting our mindset can transform how we feel—and how our patients feel too.

Instead of:🧠 “Here comes another problem.”Try:💬 “How can I help this person today?”💬 “What matters to them right now?”

This aligns beautifully with a person-centred care approach, championed by NHS England [2]. It keeps the focus on the individual, not just their condition, and reminds us that healthcare is a human interaction first.

The Science of Smiling (Yes, Really)

Something as small as a smile can carry huge weight in a consultation.

✅ Smiling builds rapport and trust✅ It boosts your own mood by releasing dopamine, serotonin and oxytocin✅ It’s contagious—your patient might smile back and feel better too

Spong (2023) outlines how smiling triggers positive neurological responses for both you and the patient [3]. In a job full of complexity, it’s a refreshingly simple intervention.

Clinician Wellbeing Matters Too

You can’t pour from an empty cup.

Looking after yourself isn’t optional—it’s essential. Caldwell (2019) even identifies the clinician feeling refreshed as one of the key quality indicators that improve consultation outcomes [4]. Taking breaks, debriefing after tough cases, and even just walking outside between sessions can make a difference.

Moulton’s The Naked Consultation [1] shares excellent, practical tips for staying well during the day—because a well-supported clinician provides better care.

Final Thoughts

MSK consultations in primary care come with pressure. But they also come with power—the power to listen, to guide, and to influence someone’s health journey in a meaningful way.

By reframing our mindset, taking care of ourselves, and embracing the small wins, we can improve both patient outcomes and clinician satisfaction.

Let’s go into each consultation not just with clinical curiosity—but with compassion, perspective, and purpose.

📌 Looking for MSK training that supports both clinical confidence and patient-centred care?

Explore our webinars, courses and resources at PrimaryCareMSK.co.uk.

References

[1] Moulton, L. (2016). The naked consultation : a practical guide to primary care consultation skills (Second edition.). CRC Press, Taylor & Francis Group.

[2] Person-centred care | NHS England | Workforce, training and education. (2017, November 9). NHS England | Workforce, Training and Education. https://www.hee.nhs.uk/our-work/person-centred-care

[3] Spong, J. (2023, July 5). Unlocking the Power of a Smile: 7 Scientifically Proven Benefits. Modern Mind Masters. https://www.modernmindmasters.com/the-scientific-benefits-of-smiling/

[4] Caldwell G. (2019). The process of clinical consultation is crucial to patient outcomes and safety: 10 quality indicators. Clinical medicine (London, England), 19(6), 503–506. https://doi.org/10.7861/clinmed.2019-0263