Changing roles of the psychologist over the past 30 years or so have been rapid and fundamental. This has led to difficulties when psychologist and doctor do not see the former's role in the same way. Psychologists achieve clinical independence for their work rather sooner than doctors do, and if this is not understood there can be difficulties in communication. If the doctor and psychologist employ different theoretical models of illness, this may affect the ease with which agreed therapeutic strategies are reached. The respective roles played by the doctor and the psychologist may be consonant, in that both are research, or both are clinically, oriented. When this is not the case, difficulties may occur. It is suggested that job descriptions should be agreed before appointments are made. Unresolved tensions concerning clinical responsibility may cause communication difficulties. It is suggested that the claims of functional leadership over status leadership be examined.