Just how demanding can we get before we blow it?

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1277
  1. Hilda Bastian (, managing editor
  1. Cochrane Collaboration Consumer website, PO Box 96, Burwood, Victoria 3125, Australia

    I don't remember exactly how I learned to be a “good patient.” I can't remember which was more powerful—the examples of my mother's behaviour and that of others in the waiting room or hospital, or the instructions to “Be good, to not complain about pain, to not take too much of these important people's time.” I do remember learning clearly that part of being “good” at the doctor's was to say whatever he or she wanted to hear. At the doctor's, it wasn't lying—it was making a good impression, and that was what mattered. It mattered especially at the hospital—you had to make sure they liked you, so you got better care and didn't wait so long. We were a family of “lower socioeconomic status” and “non-English speaking background,” and the most important thing was to nod and say “Yes, doctor” no matter how mystified you were—and no matter how far-fetched the advice was in terms of our “social context.” “Getting plenty of rest?” “Yes, doctor.”

    I was a child in the 1960s. In the 1980s, when I became a health consumer advocate, at first I jumped into the active, rights driven, approach so clearly described by several writers in this issue. But there was always …

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