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Prescribing decisions are influenced by doctors' perceptions of
patients' expectations, but there is doubt about the accuracy of these
perceptions. On p 484 Britten et al describe an in-depth study of
general practice consultations in which they interviewed patients
before and after their consultations and compared patients' accounts
with recordings of the consultations and doctors' accounts of what had
happened. All the misunderstandings were associated with lack of
patients' participation in the consultation in terms of the voicing of
expectations and preferences or the voicing of responses to
doctors' decisions and actions. Many were based on inaccurate guesses
and assumptions. In particular doctors seemed unaware of the relevance
of patients' ideas about medicines for successful prescribing.