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Patients to be asked what they need from doctors

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4690 (Published 12 July 2019) Cite this as: BMJ 2019;366:l4690

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Re: Patients to be asked what they need from doctors

We are debating the future of doctors at an alumni and current students workshop at Guy's Hospital on 26th September.

Much health and continuing care is provided by patients and famlies themselves and maybe the commonly perceived passive status of patients in health creation and health and social care will change with the emergence of communication technologies and a greater emphasis on problem solving alongside traditional medical interventions.

Knowledge, skills and attitudes that in the past were only expected to be found in professionals are now becoming common in citizens, carers and families. The use of shared care records is facilitating this partnership of health between citizen and health care provider. The most significant change that we see with who carry their record is one of ‘knowledge’ and ‘ownership’. This results in a psychological shift in the doctor-patient relationship from one of external control, where the doctor exerts control with a passive patient, to one of internal control where the doctor advises a knowledgeable patient in a two way ‘adult’ relationship.

Full access by patients to records, shared plans, clinical details and natural histories will allow patients to make better responses to crises and changes. Patients will be educated to respond differently to these situations and will use their medical records in a constructive way to prevent the need to contact a service provider for advice.

Patients enter their own clinical data into the records. Diabetic patients will enter their glucose levels. Epileptic patients will the number of their fits, absences or fugues. Hypertensive patients will enter their BP readings. Patients with other conditions enter other data to their records. Patients enter how they feel.

All patients’ carers will have access to the whole record with the patient’s consent. The patient will have the say about the level of access. He will decide who can see the information and will decide which information he does not want to see himself. This information access will be controllable by granular computer technology and will be defined and elucidated by the patient at the beginning of the record and put up for time related review.

Patients may want a second opinion or to move to another provider and will share the record from the old provider with the new specialist to see everything so as not to have tests repeated causing expense and delays.

Competing interests: No competing interests

07 August 2019
Richard Fitton
Data Protection officer for 60 General practices
West Pennine Local Medical Committee
Glossop, Derbyshire