Family Practice Vol. 19, No. 6, 709
© Oxford University Press 2002
Book Review |
The resourceful patient.
JA Muir Gray. (173 pages, £14.50.) eRosetta Press Ltd, 2002. ISBN 1-904202-00-4.
Professor of Primary Care Medicine, University of Hull
A thousand years ago the Chinese invented moveable type, while Johann Gutenberg developed the printing press in 1450, and now Muir Gray, with Harry Rutter, has created a simultaneous conventional paper, web-site, and electronic (‘e-book’) publication. The format is revolutionary, but what of the content? Pretty radical too! The imbalance, or ‘asymmetry’ of the doctor– patient relationship has been gradually redressed through research such as Tuckett’s "Meetings between experts", and the "patient-centred clinical method" of Moira Stewart and colleagues, but Muir Gray has taken the process a step (leap?) forward by proposing that patients should have free access to (high quality) information about their health. His position as Director of the UK’s new and emerging National Electronic Library for Health may not be entirely unconnected with this dream.
As befits so self-consciously ground-breaking a book, The Resourceful Patient wonderfully reflects the literature of past centuries, from George Eliot’s Middlemarch to PD James’ The Black Tower and from George Bernard Shaw’s The Doctor’s Dilemma to David Sackett’s Evidence-based Medicine. Muir Gray skilfully weaves a story of the rise and fall of medical power, the nature of medical work and then the emergence of empowered, or resourceful, patients.
Incidentally, Article 10 of the European Convention on Human Rights asserts that citizens have the right "to receive and impart information and ideas without interference by public authority" (which in the UK includes the National Health Service!). This book seeks to define both the technical and ethical frameworks that would be needed to enable patients fully to participate in their health care decision-making. This draws on McKinstry’s1 study that suggested that 40% of patients would choose to be actively involved in decision-making, and on a North American study of breast cancer patients2 which showed that 22% preferred a patient-led style of decision-making, 44% a collaborative approach and 34% would prefer to delegate responsibility to the doctor.
The book’s format also allows free use of web-links, both to book details and literary links, such as "la maladie du petit papier", a splendid historical gem attributed to a certain Sir Edward Waine, but modified by Douglas Carnall into "la maladie du grand print-out"!
From my perspective as a teacher, seeking to promote patient–centred consulting, The Resourceful Patient will be a first class source of references and quotes. It will be a powerful tool in empowering resourcefulness in the hands of lay members of NHS bodies such as Primary Care Organizations and members of patient organizations, or patient participation groups. Not that these are not already resourceful, but here is a book/web-site/e-book that adds more resources to their resourcefulness! It is a fantastic creation, well worth a visit to the web-site, followed by a visit to a bookshop (or e-bookshop!).
References
1 McKinstry B. Do patients wish to be involved in decision making in the consultation? A cross-sectional survey with video vignettes. Br Med J 2000; 321: 867–871.
2 Degner LF et al. Information needs and decisional preference in women with breast cancer. JAMA 1997; 277: 1485–1492.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||