G Bolton. Paul Chapman Publishing Ltd, 2001, £16.00, pp 219. ISBN 07619 6729 (PBK)

• Writing and Professional Development

During the last twenty years professional people have seen their autonomy being gradually eroded and the decision making process becoming mechanised. Economic and political forces have contributed to this change, transforming the professional person into an operative. The advent of evidence based medicine and clinical effectiveness has propelled the medical profession into a structured protocol approach. The art of being a good doctor is undermined and sidelined. In parallel the only research that is deemed acceptable is that based on groups of patients. The value of what can be learnt from one patient is rubbished as anecdotal. These changes are totally at variance with the uniquely personal response that is necessary in a patient centred approach in the caring profession, where there is a great need to access the world of feelings and fantasy. …