The modern patient - threat or promise? Physicians' perspectives on patients' changing attributes.

Abstract

OBJECTIVE: The study focuses on physicians' ideas of their patients' attributes and examines how the German medical community employs the currently popular idea of the modern patient (mündiger Patient). METHODS: The official publication of the German medical community, the weekly journal "Deutsches Arzteblatt", was searched for articles addressing the topic of the modern patient during the 10-year period 1996-2005. A total of 73 articles were analyzed using qualitative research methods and from the perspective of discourse analysis. RESULTS: Assessments of the modern patient are heterogeneous. There are four definable discursive clusters ('law and ethics', 'knowledge and information', 'structural health care problems' and 'funding issues'). Each position views the modern patient in characteristic ways. CONCLUSION: Attributes currently ascribed to patients fit into broader modernization processes of health care systems. This involves new opportunities for patients' empowerment as well as new forms of involvement and the burden of self-reliance. PRACTICE IMPLICATIONS: Reflecting on the complexity of physicians' views of patients 'desirable' attributes within a particular physician-patient interaction, helps to assess the physician's expectations of the patient, e.g. prevailing ideas on autonomy or responsibility and whether they really are in the interest of the individual patient.