Idealistic, impractical, impossible? Shared decision making in the real world

[摘要] A good idea but not so easy to put it into practice. This is how Blakeman and others in this month's Journal (page 407) describe the reactions of GPs to the ‘expert patient’ programme.1 Doctors are supportive of the expert patient concept and yet admit that they struggle when it comes to working with the ideas and developing the specific knowledge and skills that are required by patients who aspire to this ideal. The new contract for general practice has also created a changed context for many consultations and both patients and professionals need to learn new skills to do this work. If self-management involves self-determination, there may be a conflict between what the patient chooses for themselves and what the contract prescribes. ‘Expert patients’, viewing the world from their individual standpoints, could well take issue with the population derived agendas set by incentivised consultations operating in UK primary care. I suspect these patients get short shrift in some practices.

[学科分类] 卫生学