Meetings Between Experts. An Approach to Sharing Ideas in Medical Consultations: By David Tuckett, Mary Boulton, Coral Olson & Anthony Williams. London: Tavistock Publications, 1985. Pp. 292.

The experts referred to in the title are both the doctor and the patient who meet in everyday general practice consultations. The authors are social scientists from the Health Education Studies Unit, Hughes Hall, University of Cambridge, England, and the senior author is also a member of the British Psycho-Analytical Society.

The core of the book is the description of a research project investigating the extent to which there was mutual communication between patients and doctors of key ideas in general practice consultations, and an evaluation of some of the causes and consequences of success and failure in these communications.

In the introduction a number of current ideas and explanations are outlined from the literature for the difficulties doctors and patients have in exchanging ideas and for the 'failure' of consultations. These range from the idea of an unbridgeable competence gap between the knowledge of doctors and that of patients, to the idea that the emotionality of the issues potentially facing the patient would inhibit both parties from speaking about the issues and to descriptions of the power and status struggles that occur between doctors and patients.

This study found that where patients had not recalled key information given, or had not understood the meaning of the information and advice, or were not committed to the recommendation, the patients had arrived at the consultation with their own 'expertise' in the form of conscious ideas about these matters and that the doctors' ideas were disparate and remained so following the consultation. The doctors had in no case recognized this let alone encouraged the patients to voice their ideas. 'Successful' consultations occurred because the patients came to the consultations with ideas and expectations that were consonant