The white paper Working for Patients assumes that patients choose general practitioners on the basis of the service that they provide and that increased competition among doctors will raise standards. To investigate these assumptions a postal questionnaire survey was carried out of 447 people who had recently registered with a new general practitioner. The results disclosed a remarkable lack of consumerist behaviour. Most people registered with their nearest doctor, and many did not register until they were already ill. Many people knew nothing about their new practice but seemed unworried by this and showed little inclination to seek information. These findings suggest that competition among general practitioners is unlikely in itself to raise standards of care.