An alliance between the healthcare professional, the patient, and the family is at the heart of effective and humane childhood medicine. When patients complain about doctors, and doctors complain about patients, this essential therapeutic alliance has been ruptured or even destroyed. Reason is usurped by fear and concordance gives way to paternalism. It should be remembered that patients often complain about doctors for the same reasons that doctors find some patients difficult to help: when patients don’t get better and they are distressed by it.¹

Drs Lindley, Glaser, and Milla have provided an interesting descriptive account of a selection of the behaviour of a small number of parents with children referred to a single paediatric gastroenterologist at a tertiary referral centre, bringing to our attention issues that should be debated further.² I have brief comments on only two of these issues; other correspondents may wish to raise more. The first relates to the importance of reflexive and quality controlled research, the second relates …