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. Today, disease and doctor centric health systems that are costly, wasteful, fragmented, and too often uncaring are provoking similar ire.
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. 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, 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. 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, patients understand the realities of their condition, the impact of disease and its treatment on their lives, and how services could be better designed to help them.
