A record of one in three consultations occurring in 10 general practice surgeries in two morning and two evening sessions was made by an observer. The results showed marked variation in the frequency of the general practitioners' use of different means of eliciting information about the patient and in forms of management. These activities were further analysed within subgroups of the patients' symptoms and some activities were shown to be influenced by patients' presenting symptoms whilst others were not. I discuss how much general practitioners' behaviour is responsive to patients' presenting symptoms and also some of the practical implications of these findings for general practice.