ABSTRACT
The author's emphasis on medical control should not be taken to mean that parents had no power to negotiate with staff. There are various ways in which patients may influence the course of action within consultations. The medium through which control of the nuts and bolts of interaction is exerted is the same as that used to create the rest of a format. Selective attention is the basis on which the whole of these little worlds rest, and participation within them is a matter of what may be defined as relevant for whom. In clinics, doctors might do many things. They could break off conversation with a mother to read or write a note, or to look at the child, or to ask the nurse a question, or to teach a student. Developmental testing on a normal child was accompanied by all kinds of congratulatory remarks from staff.
