Some patients are happy for doctors to make decisions

Editor—I agree with Bastian that the relationship between doctors and their patient is fundamentally changing and that many patients should be more closely involved in the decision making regarding their health needs.¹ I do, however, not accept Bastian's statement that doctors do not have a sophisticated understanding of the consultation process and wish to raise a point that is often overlooked by many people in consumer organisations.

An appreciable body of patients in the community is more than happy to offload the decision making about their treatment to the doctor. Many of these patients are intelligent, motivated people who approach the medical profession for advice based on knowledge and experience. As an anaesthetist I have spent much time discussing with patients the pros and cons of one form of perioperative analgesia versus another, and, almost invariably, when I ask the patient about their preference the response is, “Whatever you think best, doctor” or “Which one would you have?”

Every patient we see is unique and should be treated as such. Some patients clearly gain reassurance from the medical profession adopting the politically incorrect paternalistic approach, and these people must not be forgotten.