Critics have noted that Fildes omitted common medical equipment of his era in order to focus on the relationship between physician and patient.

[4] The most important personal influence was probably the death of Fildes' first child, his one-year-old son, Philip, from typhoid fever on Christmas morning, 1877.

[6] Documentation of Fildes' work with the homeless reveals that a child was once brought into the studio by a labourer, a scenario which prompted the painting The Widower (1876).

[9] The cottage setting has led some to believe that the painting was ordered by Queen Victoria to honour her own physician, Sir James Clark.

[5][13] In 2002, Douglas wrote in the British Medical Journal, "So his manner is all, and Fildes captures it forever: the furrowed brow; the hand propping the firm bearded chin; the calm, concerned authority".

[4] The artificial light from the lamp on the table and the natural rising sunlight beginning to shine through the single window suggest that the doctor has been in attendance all night.

[9] An easily missed medicine bottle is placed in the shadow of the lamp and in close proximity to the doctor and his control, not the parents'.

[9] Fildes stated that his choice of subject was "to put on record the status of the doctor in our own time",[4] but his depiction of 19th-century healthcare is not entirely accurate.

There is no stethoscope, microscope, sphygmomanometer, or thermometer in the picture, well-known instruments of physicians in the late 19th century which saved time.

[4] It has also been pointed out that it was unlikely that a Victorian physician would make an overnight home visit to a poor family, such services being available only to the middle class and the wealthy.

[6] It epitomises an idyllic kind of medicine[1] and has often been used to illustrate the virtues of a good doctor and the inadequacies of the medical profession.

He continued: "A library of books written in your honour would not do what this picture has done and will do for the medical profession in making the hearts of our fellow men warm to us with confidence and affection".

[9] Seen today as "Victorian spin" by some, in its time the depiction of the doctor as a hero serving the poor raised the status of the medical profession during a period when public opinion was critical of the increasingly impersonal nature of medicine.

[18][19] As late as 1951, the painting was used in advertising for Wyeth pharmaceuticals, which repeated the story that Queen Victoria commissioned it, adding: "the pictured child recovered despite the inadequacies of her humble home–a tribute to her doctor's genius and to the progress of medical science".