ABSTRACT
This chapter deals with a reconsideration of Goffman's work on frames; a suggestion as to the extent to which the bureaucratic format is in general medical use; a hypothesis as to its origins; and finally some discussion of its possible drawbacks. Young children themselves were obliged to play a part in their exclusion from the adult conversation. In general, one can distinguish two broad strands within the bureaucratic format which stand in need of explanation. On the one hand there is the tight medical control of the consultation, with the closely related features of impersonal treatment and the appeal to collegial rather than individual expertise. On the other hand, there are the idealization of the patient's character and competence; the ideal of service; the right of patients to criticize that service, and at least the semblance of rule by reason rather than by fiat.
