Editor’s Note: This is another commentary generated as a result of an email group discussion about the nature of the doctor-patient relationship and participatory medicine. I appreciate Paul’s perspective, which also points out what a big job we have ahead of us to get our arms around defining, studying, and promoting participatory medicine. –CWS

Abstract

Keywords: Participatory medicine.
Citation: Bearmon P. One size doesn’t fit all. J Participat Med. 2011 Jan 7; 3:e4.
Published: January 7, 2011.
Competing Interests: The author has declared that no competing interests exist.

There is no end to the enumeration of variables attached to treating others as one would like to be treated, a concept which is central to participatory medicine. Lists of ideal behavior are legion in nature. But lists don’t easily lend themselves to definable actions.

Much of participatory medicine relates best to ongoing primary care relationships and those involving chronic issues. I have worked for more than 30 years as an Urgent Care/Emergency physician, and found that an unstable ER cardiac patient is looking for a different interaction than a patient with chronic issues or health concerns working with a primary care provider. This isn’t an excuse for excluding patient input, but simply recognition that variation in settings and health problems means different types of relationships will ensue.

It also needs to be acknowledged that within a given type of practice there is no one type of relationship that works for all patients. Some patients might be okay with the “medical home” concept; others would find this intrusive. Some patients want their hands held; others want their docs to keep their hands to themselves. Some want a longterm primary care relationship, others want only episodic interactions.

Goals and suggested mechanisms for reaching goals for participatory medicine, including altering the use of terminology (“patient,” “provider,” etc) as well as various strategies for bringing about better patient involvement in their own health care, are best developed within a well defined and specific clinical context.

Copyright: © 2011 Paul Bearmon. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the author(s), with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.