Stop the silent misdiagnosis: patients’ preferences matter

BMJ 2012; 345 doi: (Published 08 November 2012) Cite this as: BMJ 2012;345:e6572

Re: Stop the silent misdiagnosis: patients’ preferences matter

This article makes explicit the approach that many general practitioners feel they already aspire to, and being aware of our personal biases and cognitive processes during the consultation can only help us to become better doctors. Unfortunately, in the UK this approach is coming under increasing threat.

Despite the government’s mantra “no decision about me without me”, the reality is that with the increasing demands from performance management, GPs are under pressure to disregard patient preferences and to manage them according to strict and simplistic protocols. The proposed new GP contract threatens to intensify this. In one of the many internal tensions within the current NHS, the claim to honour the wishes of the patient is at odds with the desire to micromanage how we treat them. As the QOF juggernaut hurtles blindly onward, shared decision making will be one of the casualties.

Competing interests: No competing interests

19 November 2012
Jonathan D Sleath
General Practitioner
Kingstone Surgery
Hereford, HR2 9HN