Yeah, I get that, my regular doctor and mechanic love me, and handing out carrots and understanding gets me what I want 90% of the time. Your advice is great for getting a good doctor to go the extra mile with discretionary care or maybe save your ass from the known shitty one in the team.

But it doesn't work when you're alone with just a bad doctor and bureaucrats, the quietly held stick is what got me the second opinion when the carrots failed which got a biopsy and changed a diagnosis from a casually dismissed cyst to a malignant tumor when it really needed to count. The patients who survived Harold Shipman didn't have the family members who were most friendly and compliant, but the ones who politely insisted on being there in the room as much as possible. The supervisor who pressed for harvesting this still living man's organs probably didn't give a fuck how nice the junkie's family were for the 2 minutes he met them, but he might have been less keen to just push forward if they had mentioned they noticed that it seemed like the doctor they watched do the reflex tests seemed to skip most of what they saw on the checklist.

A patient doesn't know what they're getting when they walk in there, and if they want to absolutely minimize risk they need to need to have both the carrot and the stick in their pocket.