Over the past 40 years, there has been a dramatic shift from the expert doctor who should be revered and obeyed to an increasing role for patients as the experts of their own bodies. As researchers, we run patient participation groups before, during, and after our studies; use qualitative methods to hear their voices; and run surveys to gain their feedback. As teachers, we ask patient advocates to share their experiences of illness with our students, and as clinicians, we aim for shared decision-making and gain informed consent before embarking upon any intervention.

This is all great and places the patient at the centre of what we do. It is also increasingly reflected in policy with a desire to give patients a choice over what clinician, what hospital, and what treatment they have. So, what is the problem?

Having a symptom, giving that symptom a name, and taking that symptom to the doctor is not as straightforward as it might seem. Is it hunger? Pain? Tiredness? Stress? Boredom or loneliness? Is it indigestion or a heart attack? Or is it just wind? Can a doctor help, and is it too........

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