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Changes in the doctor/patient relationship
Harold Lambert Physician
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I think there have been quite substantial ones, particularly a continuing decline of deference, thank goodness, which of course is part of a lar- larger societal thing and a longer historical background. I mean, you can only think about, about the affair of King Edward VIII and Mrs. Simpson being totally hidden from the country before the Bishop of Bradford blew the gaffe and then even more recently nobody knew about Churchill being so ill and having strokes, because- And he was actually, actually receiving people, wasn't he, while he, while he was ill and nobody, and nobody was kind of allowed to know that. And we, you know, hoi polloi, just the general people of the country weren't supposed to be involved in this. And people like, say, Harold Nicholson going in as a parliamentary candidate to some poor place, where he'd never even look at the actual constituents at all because that was what you did and the people just followed or accepted it. I think the analogue in medicine was the fact that, certainly when I was a student, it was doctor telling patients what's what most of the time. And I think that has changed quite substantially although as you, you and I know, you still see pretty b- big echoes of it sometimes in, in medical practise. What do you think it was that started the change, Harold? I mean, because, post war, for me anyway, it was still quite a commanded, controlled sort of society, wasn't it? Yes, yes. I mean there were ration books, there were, you know, people did what they said. I mean the, the, the Caribbeans came to Brixton and were told in the first, the- Empire Windrush this is where you sleep tonight. It was very- Yes. It was like that. I don't really know, was it to do with the general economic well-being? There just weren't as many terribly poor people who couldn't possibly have a say and having some food and housing, I suppose, makes you feel a bit more entitled to say what you think your rights are. General, general rise of feeling of, of your rights over automatic subservience and you still see when people talk to people the body language shows that somebody is addressing somebody and somebody else is receiving the address. I think you see that quite commonly in medicine too as well as in ordinary life and it, it- I have to say, it irritates me extremely.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: decline of difference, student, body language, patients, doctor

Duration: 2 minutes, 44 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008