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When patients take charge of their own health care

The Québec health system is turning towards a “patients as partners” paradigm in which the patient is considered a member of the health care team. This approach is redefining the relationship between health professionals and their patients. Djahanchah Ghadiri, an administration researcher at HEC Montréal, and his co-investigators conducted participant observation and interviews with patients, family doctors and promotors of this shift to identify the issues.

The results show that patients are more proactive than one might think when it comes to their health care.

The results show that patients are more proactive than one might think when it comes to their health care, regardless of whether this is encouraged as part of a “patients as partners” approach. However, doctors do not always take into account the fact that patients assess and adapt their prescribed treatments according to their own experience and knowledge.

The personal initiatives taken by some patients may arise from learning that allows them to properly assess the health care they receive and can be beneficial. For example, a long-time diabetic may redo her foot dressing at home if it does not meet her needs. However, such patient engagement can sometimes lead to more risky behaviours. For example, a patient with kidney disease might be tempted to self-inject his own medication, thereby running the risk of peritonitis.

It is therefore crucial for both patients and physicians that the latter take such behaviours into account and engage in constructive dialogue. Indeed, the “patients as partners” approach aims to establish a more egalitarian power relationship, contributing to better dialogue and constructive collaboration between health care professionals and patients. As a result, this shift could better guide patient behaviour outside the doctor’s office.