Intended for healthcare professionals


Patients are experts in their own field

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1276

The interests of patients and healthcare professionals are intertwined

  1. Ian Kennedy (, shadow chairman
  1. Commission for Healthcare Audit and Inspection, Department of Health, London

    The notion of being concerned with the interests of patients is not new. It is as old as medicine. What is new, or relatively new, is the question of how that concern is best dealt with. To put it another way, who is the best judge of a patient's interests? For almost the whole of the history of modern medicine, this question was not asked because the need to ask it was not recognised. A patient's interests were best judged by the patient's doctor. That was part of what a doctor did. Patients knew nothing of clinical matters. How could they be expected to decide what was good for them? Indeed, it was cruel to impose this burden on them.

    Times have changed. A better educated population, exposed through a variety of media to the idea of choice and impressed by the language of rights, began to see themselves differently. They were no longer passive receivers of goods and services, grateful for whatever came their way, but consumers with choices who were entitled to expect good quality and to complain if they were not satisfied.

    In relationships between professionals and clients, of which the patient-doctor relationship is one example, the accommodation of this change has not been …

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