TY - JOUR
KW - Humans
KW - Patient Participation
KW - Physician-Patient Relations
KW - e-patient
KW - Paradigms
KW - participatory medicine
KW - patient empowerment
KW - patient engagement
KW - Patient-clinician relationship
AU - Dave deBronkart
A1 - 
AB - Professionalism in any field requires keeping pace with change, and nowhere is it more true than medicine. Knowledge flow has changed dramatically since today's accreditation standards were developed, and change continues more rapidly than ever. It's time for a fresh look at how best to achieve care in this altered environment, where valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change. The power structure of the clinical relationship is inevitably altered as constraints on patient knowledge are loosened by the internet, apps, and devices, undermining a paradigm of patients as uninformed recipients of care based on a one-way flow of wisdom from providers. Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model. To understand this sociological (yet scientific) change, this article reviews the role of paradigms in the history of sciences as described in Thomas Kuhn's landmark book The Structure of Scientific Revolutions and describes how these anomalous patient stories force the conclusion that the traditional paradigm of patients is no longer supportable and a new paradigm is needed. This in turn means our standards of professionalism and appropriate care must be updated, lest we fail to achieve best possible care in our increasingly overburdened system. Our new standard must be to teach clinicians to recognize, welcome, and work with empowered "e-patients" in the new model of participatory medicine.
AD - 1 Society for Participatory Medicine, Nashua, NH, USA.
BT - International journal of psychiatry in medicine
CP - 5-6
CY - United States
DO - 10.1177/0091217418791461
IS - 5-6
JF - International journal of psychiatry in medicine
LA - eng
M1 - Journal Article
N2 - Professionalism in any field requires keeping pace with change, and nowhere is it more true than medicine. Knowledge flow has changed dramatically since today's accreditation standards were developed, and change continues more rapidly than ever. It's time for a fresh look at how best to achieve care in this altered environment, where valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change. The power structure of the clinical relationship is inevitably altered as constraints on patient knowledge are loosened by the internet, apps, and devices, undermining a paradigm of patients as uninformed recipients of care based on a one-way flow of wisdom from providers. Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model. To understand this sociological (yet scientific) change, this article reviews the role of paradigms in the history of sciences as described in Thomas Kuhn's landmark book The Structure of Scientific Revolutions and describes how these anomalous patient stories force the conclusion that the traditional paradigm of patients is no longer supportable and a new paradigm is needed. This in turn means our standards of professionalism and appropriate care must be updated, lest we fail to achieve best possible care in our increasingly overburdened system. Our new standard must be to teach clinicians to recognize, welcome, and work with empowered "e-patients" in the new model of participatory medicine.
PP - United States
PY - 2018
SN - 1541-3527; 0091-2174
SP - 350
EP - 360
EP - 
T1 - The patient's voice in the emerging era of participatory medicine
T2 - International journal of psychiatry in medicine
TI - The patient's voice in the emerging era of participatory medicine
U2 - 30114957
U3 - 10.1177/0091217418791461
VL - 53
VO - 1541-3527; 0091-2174
Y1 - 2018
Y2 - Nov
ER -