A study of the bureaucratic context of medical work. It emphasizes the structural context in which individual action occurs in the medical world. The author argues that there are fundamental and irreconcilable conflicts inherent within medical consultations, and these occur, not just between staff and patients, but even within the various things that any one individual may want or have to do. He aims to render the transparent apparent, to set the business of diagnosis, treatment and their discussion within an organizational framework. The text's concern is with the consultation itself and more specifically with its overt social form. The question it asks of each consultation is: what kind of social occasion is this? It demonstrates that there are special sets of rules that make medical consultations distinct social occasions, rules that are clearly informed by the location of the action within a bureaucratic setting. The author's model emphasizes the doctor's technical authority over the patient, and the impersonality and neutrality of medical intervention.