The role of patients in UK primary care: from the extraordinary to the essential.

Abstract

Why involve patients in primary care practice, research, or policy at all? Surely the trained health professional or policy maker knows best? I believe that every GP, researcher, and policy maker works to improve the healthcare system and the quality of healthcare for patients. Working closely with patients and the public can help GPs, researchers, and policy makers to improve their work, and can also create a virtuous circle, leading to improved quality of care for patients. Traditionally, the doctor ‘took’ a history, hardly ever admitting ignorance or uncertainty and when a test was inconclusive had a tendency to imply that the lack of diagnostic certainty was somehow the patient's fault. In her 1880s diary, Alice James sums up the effect that the medical interview could have on patients: > ‘One has a greater sense of intellectual degradation after an interview with a doctor than from any human experience.’1 I fear things have not changed as much as doctors might believe. I have felt like this in the past and, in my years as a participant, volunteer, and employee of the Expert Patients Programme (EPP) it came up time and time again. Patient and public involvement (PPI) in primary care research and policy began with the changes in society of the 1960s, with mental …