The worthy patient: Rethinking the hidden curriculum in medical education

Robin T. Higashi, Allison Tillack, Michael A. Steinman, C. Bree Johnston, G. Michael Harper

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


This paper examines how physicians determine the quality and quantity of time to devote to each patient, and how these decisions are taught to physicians-in-training as part of the hidden curriculum in medical education. The notion of moral economy is used to analyze how judgments of patient worth come to guide and influence interactions among physicians and physicians-in-training and patients, and how these interactions impact medical care. However, this paper also questions the notion of the hidden curriculum as a static or reified concept. Instead, the paper uses participant narratives to show how physicians-in-training are not simply passive recipients of the hidden curriculum but also actively resist judging patients based on perceptions of worth, even as they learn to operate within a moral economy of care.

Original languageEnglish (US)
Pages (from-to)13-23
Number of pages11
JournalAnthropology and Medicine
Issue number1
StatePublished - Apr 1 2013
Externally publishedYes


  • biomedicine
  • ethnography
  • medical anthropology
  • moral economy

ASJC Scopus subject areas

  • Anthropology
  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health


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