This article reviews the contribution which papers in this collection make to a changing focus in the study of medical interactions—one which pays closer attention to the role of the patient and patient perceptions, both within the medical consultation, and beyond that in the everyday world in which symptoms are first experienced by patients. What emerges from the studies reported here is a less simplistic picture than the one represented in research about the medical interview, as though that is a standard, unidimensional form. We begin to see instead how patients actively participate in medical interactions and in decisions about treatment. We see also how medical interviews unfold according to the communicative choices made by both doctors and patients—a more genuinely interactive approach than hitherto. A number of inter-related themes are identified, in which the patient's role is foregrounded: these include the initiatives which patients make; how they break free of the medical agenda in order to express their concerns; how delicate issues are handled in the interview; patients' lay theories and self-diagnoses (this from a more ‘holistic’ view of the patients' experience); and misalignments between lay and medical perspectives.