The medical consultation
Contemporary research has confirmed the pers1stmg empirical rarity o f the patient participation model of the consultation. Indeed, this has been a recurrent theme from the early studies of the patient perspective in the 1 970s and 1 980s through to the present day. Stimson and Webb ( 1 97 5 ) first introduced the patient' s perspective of the medical encounter. Their study revealed the contrast between the passive and deferential demeanour of patients during the consulta tion, and the critical appraisal they brought to bear on this afterwards (Box 6 . 1 ) . Byrne and Long ( 1 97 6 ) found that the overwhelming maj ority of the 2 500 consultations they analysed were dominated by the doctor. Attempts to elicit patient ideas or concerns, or to invite patients' active participation in the interview were rare . Their argument that medical care and health outcomes would be improved by encouraging patients to play an active role in managing their healthcare was taken forward in the 1 980s by Tuckett et al. ( 1 98 5 ) .