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What I know I owe to patients

BMJ 2014; 349 doi: (Published 01 December 2014) Cite this as: BMJ 2014;349:g6734
  1. James Munro, chief executive officer, Patient Opinion, Sheffield S3 8EN
  1. James.Munro{at}

For James Munro, listening to and understanding patients has provided far more medical insight than formal training

When I was young I trained in medicine. I studied hard and learned many things. I was anxious, but because I knew that I knew a lot, I wasn’t afraid to make decisions. I thought I was a pretty good doctor. But I didn’t know quite how much I didn’t know.

Over the past decade, as one of the team running Patient Opinion (, a non-profit online public feedback service for UK healthcare, I have read thousands of stories of care—good and bad—contributed by patients and their relatives. Many are written with remarkable insight and thoughtfulness. And so I have come to know some of what I didn’t know then.

Arrogance of medicine

I didn’t know how much patients see. Many times as a young doctor I was tired, irritable, scared, or even angry with my patients. There were times when I didn’t get on with other staff or they didn’t get on with me. In many of the stories I have read it is painfully clear that patients and relatives often see all of this. My obliviousness wasn’t …

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