The study compares the genre of medical case reports (MCRs) written in the 21st century with its 19th-century counterpart. Specifically, it focuses on the textual representation of the doctor-patient relationship in this genre, particularly in the case presentation section. A two-million-word corpus of present-day MCRs was built from two online journals from 2007 to 2010, with a concordance program being used to analyze them. For the analysis of 19th-century MCRs, twelve randomly selected reports from 1840 to 1895 were collected and carefully read. The results demonstrate a relatively equal position of patients in the doctor-patient relationship in the personalized rhetoric of 19th-century MCRs. Conversely, the analysis of present-day MCRs points to a biased representation of patients, owing to the rhetoric of biomedicine. The study finishes by discussing the concept of Medicine 2.0, which has the potential to bring the ‘voice’ of the patient back into the genre.