BMJ  2008;336:894 (19 April), doi:10.1136/bmj.39549.633530.94

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You do agree, don’t you?

The first 150 words of the full text of this article appear below.

It was a good idea. It still is. But somehow, something’s up with "concordance" in clinical care. This concept was introduced to help modernise how medical advice and interventions are discussed, offered, and decided on between professionals and patients. Sadly, though, it remains widely misunderstood and misused.

Concordance challenged traditional models of health care, where the professional dictated treatment that the patient was expected to accept without questioning or complaint. The patient’s failure to show such compliance was seen as a key reason why treatment might fail. While seductive, this notion of compliance was hopelessly flawed, even at a time when patients were meant to be seen and not heard except, presumably, to report their symptoms and mumble their eternal gratitude.

So compliance became a dodgy word in polite company and was largely replaced by "adherence." This more neutral term captures the extent to which patients follow the recommendations that . . . [Full text of this article]

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All the Cs

Fiona Godlee
BMJ 2008 336: 0. [Extract] [Full Text]

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No, I don't agree

Jeffrey K Aronson
bmj.com, 4 May 2008 [Full text]

Re: No, I don't agree

Ike Iheanacho
bmj.com, 9 May 2008 [Full text]

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