I am a good patient, believe it or not

doi:10.1136/bmj.326.7402.1293

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Alejandro R Jadad (ajadad@uhnres.utoronto.ca), director1,
Carlos A Rizo, research fellow1,
Murray W Enkin, consultant1

¹ Centre for Global eHealth Innovation, University Health Network and University of Toronto, Toronto, Canada M5G 2C4

Correspondence to: A Jadad

What issues will the “good patient” of the future have to deal with?

Introduction

As clinicians and medical researchers, we have been taught and socialised to think, write, and act as physicians, but we, and our friends and families, have also been patients. We all try to be good patients. Our experiences as patients and our perceptions of those experiences have sometimes differed radically from what we would have expected from our medical perspectives. Our recent, real, and personal experiences illustrate the different ways in which we try to be “good patients.” But what does that term really mean? In the past the good patient was passive and did not dare to challenge the judgment or recommendations of the physician. The good patient of the future might be the very opposite.

Our experiences

Murray: My dentist's receptionist stopped me last week with a question as I was leaving her desk. “You used to be an obstetrician,” she said, and explained her problem to me in uncomfortable detail. Her current obstetrician had suggested an operation to prevent miscarriage, and she was not confident that it would be safe or effective. To my suggestion that she request a second opinion, she responded that she couldn't even dream of doing so. Her doctor, she feared, would consider that as lack of respect for his opinion, and he might not continue to look after her.

Carlos: The health professional who catheterised me after my recent appendectomy used the anaesthetic gel simply as lubricant, without waiting for the anaesthetic to take effect. Neither I nor my wife, who is also a doctor, openly questioned the neglect of this simple precaution, which converted an unpleasant procedure into an unnecessarily painful one. Why did we let that happen? Did we think that being passive and compliant made me …