The non-patient’s view

Abstract

Roy Porter's article 'The Patient's View' stimulated a major change in medical history. In many ways it defined the new social history of medicine, which since the 1970s had been challenging doctorcentred histories and opening new approaches and topics. Many historians took up Porter's invitation to rewrite medicine's past 'from below', but I argue in this chapter that they have not been radical enough and have missed one of his major challenges. The overlooked item is the last on his agenda for future research:We should stop seeing the doctor as the agent of primary care. People took care before they took physick. What we habitually call primary care is in fact secondary care, once the sufferer has become a patient, [and] has entered the medical arena. 1 Porter is pointing to the importance of self-diagnosis and selftreatment -the beliefs, behaviours and actions of sick people who did not go to the doctor and remained 'non-patients'. In time and if symptoms persisted, they might have seen a medical practitioner. Though not addressed in this chapter, an important question therefore is what it took, in terms of beliefs, symptoms, opportunities and resources, for a person to move from being a 'non-patient' to a patient. This issue has become an important policy issue in the early twenty-first century, in terms of demand on health services.Exploring this new area of ignorance requires historians to explore familiar sources in new ways and to find new sources, many of which have previously been regarded as non-medical. Historians of