One of the buzzwords we keep hearing in the NHS these days is “choice”. The concept of patient choice is frequently cited, particularly by non clinicians, without there being any apparent thought about what that actually means.
If you take your car to a mechanic, and he diagnoses a problem, I don’t think many of us would consider it appropriate to tell the mechanic how to fix the problem. So why is this considered a good idea in medicine. The older generation of patients tend to have no truck with this idea and many of them seem not even to want too much information about their condition. This is the age group who are most likely to be taking medication prescribed by their doctor, without actually knowing, or even caring what it’s for. They simply trust their doctor to act in their (the patient’s), best interests.
The younger generations however are more likely to want information and choice, but can any amount of information given to a lay person really give them the basis to make a truly logical decision. I’m not advocating that patients be treated without informed consent, just that a little professional advice is often appropriate.
This is especially important when your patient gets all his medical information from the Daily Mail, or some similarly informative rag. And when you throw in the whims of fashion the extremes of “patient choice” can lead to a demand for some very dubious treatments.