Drug-related disease and the kidney.

(5) No patient should be woken before 7 30 am. The traditional grounds for starting their day earlier are no more or less valid than those used to exclude women from all-male colleges and medical schools. Longer term, the educational changes that will be needed include a review of nursing and medical curricula to correct the balance between their scientific and experiential components. A new subject should be introduced into the curriculum: the social and psychological determinants of interactions between health professionals and patients, including harmful forms of care-giving and their causation. Both the qualifying examination (SRN, MB, BS, etc) and the specialist examinations (FRCS, MFCM, MRCP, MRCPsych, etc) should include obligatory questions on these topics. Departments for the study of staffpatient relationships will be needed in medical and nursing schools, and they might be funded perhaps by the royal colleges, the Patients' Association, the TUC, and the Institute of Health Service Administrators. The significance of grief, illness, admission to hospital, and surgical procedures should be discussed in general textbooks, and, for example, accounts of conditions such as glaucoma, emphysema, or colostomy should include their effects on the patient and his family, and on his nurse and doctor. Conclusions