The BMJ has called for a patient revolution, a “fundamental shift in the power structure in healthcare” in which patients improve healthcare, and not just for themselves. This is not just about engaging patients with specific decisions affecting their care, moving away from the idea of doctors’ orders or compliance, in which patients take the dose of medicine prescribed for them. It is about opening up the whole decision-making process to patients as partners. It means greater openness about the extent of uncertainty in diagnosis and treatment for individuals, as well as patient participation in the development, design and implementation of new healthcare systems and policies.
The problems identified with healthcare are numerous and serious – too much medicine, secret clinical trial results, fragmented care systems, and vested interests, both professional and commercial. These articles argue that expertise in sickness and health can be found as much outside medical circles as within – and that this expertise can and should be harnessed.
The platforms and mechanisms needed for this patient partnership are starting to emerge. Just looking at the traditionally opaque area of clinical trials, the AllTrials campaign has had great success this year using social media to shine a light onto some of what is not known. Yesterday, Simon Denegri, National Director for Public Participation and Engagement in Research at the National Institute for Health Research (NIHR), told the House of Commons Science and Technology Committee about the OK to Ask campaign, which aims to encourage people to ask their doctor about clinical research.
Evidence will be at the heart of all this – understanding it and asking about it.
Moynihan R. The future of medicine lies in truly shared decision making. BMJ 2013;346:f2789
Richards T et al. Let the patient revolution begin. BMJ 2013;346:f2614.