Intended for healthcare professionals


Let the patient revolution begin

BMJ 2013; 346 doi: (Published 14 May 2013) Cite this as: BMJ 2013;346:f2614
  1. Tessa Richards, analysis editor1,
  2. Victor M Montori, professor2,
  3. Fiona Godlee, editor in chief1,
  4. Peter Lapsley, patient editor1,
  5. Dave Paul, secretary of the patient advisory group 2
  1. 1BMJ, London WC1H 9JR, UK
  2. 2Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA
  1. trichards{at}

Patients can improve healthcare: it’s time to take partnership seriously

A hundred years ago George Bernard Shaw lambasted the medical profession as a conspiracy against the laity.1 Today, disease and doctor centric health systems that are costly, wasteful, fragmented, and too often uncaring are provoking similar ire.2

Despite the best intentions and undoubted skill of many who work within healthcare, access to care, and its quality, vary markedly, and most people in rich countries access a confusing smorgasbord of tests and treatments whose merits are hyped and harms underplayed.3 Patients lack information on practice variation, the effectiveness of their care, and the extent of medical uncertainty. Practice is informed by an incomplete research base bedevilled with selection and reporting bias,4 and at worst fraud. The preservation of institutional bureaucracies, as well as professional and commercial vested interests, have consistently trumped the interests of patients. The healthcare industrial complex stands accused of losing its moral purpose.5 This corruption in the mission of healthcare requires urgent correction. And how better to do this than to enlist the help of those whom the system is supposed to serve—patients? Far more than clinicians, …

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