One of my young relatives was playing recently in state Little League championships. His younger brother, age 7, was a little bored with the proceedings and, a frequent visitor to ball fields, wandered off to the concession stand.

“I want something to drink,” he announced to the proprietor, “but I don’t have any money.”

Listening to this story begin, I thought, “Oh, he’ll be sent away, or perhaps he’ll get a cup of water.”

But no, that’s not what happened.

“Huh,” the proprietor said thoughtfully, eyeing the boy barely as tall as the counter, “I have some advertising flyers here.  If you take these and pass them out to adults in the stands, one per person or family, I’ll give you a Gatorade.”


The boy didn’t hesitate.  He grabbed the stack of flyers that was inches thick, enlisted the aid of a friend (Tom Sawyer, anyone?), passed the flyers out as directed, and returned to collect his reward, which he was duly given.

My siblings and I laughed when we heard this story. 

I said to them, “We would never have done anything like that when we were kids. The rules were the rules.  We understood very clearly that if something we wanted cost money, and we didn’t have any money, then we couldn’t get the item we wanted.  It was black and white.  There was nothing to discuss.  We wouldn’t have complained about it -- or even asked anyone to give us the money -- much less approached the business owner with this problem.”

My brother and sister agreed.

Our 7-year-old relative, we concluded, didn’t seem to view the frameworks he was exposed to as being even guidelines, much less rigid rules.  He seemed to view them as suggestions, a place to start the discussion. 

He managed something none of us would have been likely to do:  announce one’s own needs and wants to the gatekeeper, expect to be taken seriously, and assume that a workable solution would surface.

What does this situation have to do with health care?  Authors writing about some research discussed on the website of the health policy journal Health Affairsfound that even highly-trained medical professionals have trouble getting what they need from the health care system, that “even experienced patients and clinicians sometimes fail to speak up or ask questions for fear of being labeled as ‘difficult.’”  In other words, they assume that nothing can be done to better meet their needs, that they simply have to accept whatever they are told.

Next week’s column will discuss researchers’ recommendations to get both health care professionals and patients to shift their thinking so that it is more like, well, that of my 7-year-old relative.