INTRODUCTION

The relationship between patients and physicians or other health professionals has steadily changed over time from an authoritarian, paternal relationship to one in which the patient is more empowered and involved in treatment choices. As the public has become more “consumerist,” people are less accepting of a passive role in their healthcare. This change allows healthcare decisions to reflect the patient's own values and priorities rather than those presumed by clinicians.

As the dynamics between doctors and patients change, the relationships among professionals are also shifting toward a “team-based” model of healthcare delivery that draws upon the range of skills and expertise needed to address health problems, particularly chronic illness. The team-based delivery model, although it brings certain benefits, can also create tensions among different parties to a patient's care program, and poses the risk that important health information for the patient may somehow get lost in the process.

The term “informed patient” presumes that people with illnesses (and healthy people) both deserve and need appropriate health information. An informed patient is enabled to become involved in his or her own healthcare, to seek out the best care, to decide on the best courses of action, and to follow the agreed-upon course of treatment. The informed patient concept, as used in this chapter, also includes non–professionally trained caregivers (often family members), because they may serve as proxies for an incapacitated patient and are often part of the social unit making decisions for the future.