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Resumo

This paper describes part of a qualitative project on patient‐doctor communication in the management of Parkinson's Disease. It explores how a group of general practitioners conceptualised the task of diagnosing patients with PD and the impact of diagnosis on a separate group of patients in terms of coherence and incoherence. My argument is that for GPs diagnosis represented a point of maximum theoretical coherence, whereas for patients it was a time of maximum experiential incoherence – a tension sharpened by reference to an analagous distinction: that between knowledge by description and knowledge by acquaintance.The paper further examines how GPs considered their own experiential knowledge helped patients by way of three key assumptions they held about PD and PD patients: namely, age, the comparatively protracted nature of the disease course and the availability of treatment. It asks how far patients found such notions helpful in their initial efforts to accept the diagnosis. I see this meeting point between two worlds simultaneously as tragic and potentially creative, with implications for more sensitive and effective interaction between patient and GP in this and other chronic illnesses.

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