Reading Balint (dont ask why) it was evident that this group of gps who had
seen the change to a free service from a paid for service had experienced a
significant change in patients attitudes. Patients did attend more. (Given
the source; they were able to sort out the underlying reason for needing
medical attention.)
The patients are described as showing more respect for a doctor who is seen
as being there for them and paid separately rather than a doctor who was
paid by them and was therefore their servant. The effect was probably
worsened by the structure of society at the time. The well-off doctor
taking money just for advice probably reduced the respect people felt.
There is an important argument as to whether charges would reduce demand or
increase expectations. The example of prescriptions shows that if demand is
reduced it is not by much.
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