If you work in a bureaucracy, or have read Jack Welch's autobiography, here's a how to get on with it guide - or at least, a big chunk of it. If you haven't read Jack Welch's book - go take a look (try "straight from the gut"). The reference here is to the one regret Mr Welch admits to: not getting on with some things sooner. At the heart of Fierce Conversations is a practical model for doing just that, and in particular handling the difficult people stuff you might rather avoid and put off. And it's not a bad model at that.
The book is written in the "American Business Book" style - chatty, with lots of anecdotes - so on first glance feels a bit lightweight. I prefer my knowledge to be well polished and structured, ideally with evidenced research, and in contrast this book comes across as rather haphazard and slapdash. But if you can stand the American style, there's gold in them thar hills.
Susan Scott's model offers a good way to make sure you deal with the things you need to deal with in conversations, and critically shows how you can avoid the collateral damage it's easy to inflict when doing so. That's the real essence of the book - how to navigate through the difficult conversations you need to have. "Fierce Conversations" is perhaps catchier than "A practical way to have the hard conversations without getting into an argument", which is what this is really about. The principles here actually offer ways to avoid dangerously wild, hostile, or vicious behaviour, which "fierce" might suggest. The model Ms Scott presents to do this is a good one. This reflects the wider trend in academic and business thinking about how to get things done - which is to recognise that it's about people, stupid. This model includes some real understanding about how things go wrong, and what to do about it.
How much use you'll find this is hard to say - I suspect it depends on the kind of person you are. I loved it, but I tend to want to go for the jugular anyway, so something that means less risk of collateral damage is really practical and worthwhile to me. If you tend to avoid the unpleasant stuff, this might be really useful in providing a way to approach those conversations, but won't answer all the issues - these can be difficult to face, and whilst preparing using the model may help, it won't change introverts into extroverts, or vice versa. So it may not really solve all the problems of how you face the meeting you need to have. It's not an answer for everything, but a good tool for your toolbox nonetheless.
It would be possible to boil down the contents and present these in a more concise and elegant form, but this is the real stuff, not fools gold: definitely worth reading, and quite possibly buying - worth the five stars.