Intended for healthcare professionals

Analysis Spotlight: Patient Centred Care

From patient centred to people powered: autonomy on the rise

BMJ 2015; 350 doi: (Published 10 February 2015) Cite this as: BMJ 2015;350:h148
  1. Dave deBronkart, speaker, policy adviser, and co-chair
  1. 1Society for Participatory Medicine, 17 Grasmere Lane, Nashua, NH 03063, USA
  1. dave{at}

Following in the path of feminists and civil rights leaders, informed patients are building a progressive social movement to improve medical care. Dave deBronkart says medicine should let patients help improve care, share responsibility, and think for themselves

The practice of medicine is intellectually demanding: it requires specialised skills and decades of training and experience. Understandably, the accepted model that has guided us for centuries is “doctor knows best.” As recently as 2001 the American Medical Association proposed this new year’s resolution to patients:

“Only your physician has the necessary experience and expertise to diagnose and treat medical conditions. Trust your doctor, not a chat room.”1

A decade later pronouncements from the Institute of Medicine, the Mayo Clinic, the World Health Organization, and others suggest that patients—individuals without specialised training—should be treated as genuine, value contributing partners in the work of medicine.2 3

If the American Medical Association in 2001 and the Belgian government (which ran a paternalistic “Don’t google” your health problems campaign last year5) are right, then the Institute of Medicine and WHO have gone mad. But I believe the opposite is true and that our thinking must change.

Inclusive approach

I have recently been appointed the 2015 visiting professor in internal medicine at the Mayo Clinic, simply on the basis of my experience with my disease and my subsequent work to change medicine’s thinking so others might benefit. I don’t reject physicians (they saved my life), and I don’t assert that patients know everything. I do know first hand that patients can truly add value, and explain why in my book, Let Patients Help.

A growing movement, exemplified by the Society for Participatory Medicine ( and the annual Stanford Medicine X conference (, asserts that patients and clinicians must collaborate. Central to its belief is …

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