Nursing, sociological and psychological research into good and bad, popular and unpopular, and desirable and undesirable patients is reviewed. A number of themes which have been linked by researchers with the evaluation of good and bad patients are identified. These are patients' illnesses and diseases, patients' behaviour, the social backgrounds of patients, patients' attitudes and staff attitudes. It is argued that much of the literature on good and bad patients is deficient from an empirical, a methodological, an epistemological and a theoretical point of view. An alternative theoretical framework is suggested, using as its starting point an interactionist conception of the nursing role. It is suggested that patients come to be defined as good or bad not because of anything inherent in them or in their behaviour, but as a consequence of the interaction between staff and patients.