QWho better than a patient can transmit to the future doctor his expectations, his experience of the disease and a criticism of the proposed actions? Who is better placed to judge whether the decisions are centered on their needs? How to explore, without it, the satisfaction of the caregiver’s service or a real democracy in health? How not to introduce this logic during medical training?
Multiple publications confirm the contribution of patients. A non-initiated could reduce them to simple testimonials. They are more than that. Patients have experiential knowledge concerning the caregiver-patient relationship, daily life, the identification of “what works” in the care system. This knowledge, shared between patients, feeds the learning of students, future health professionals.
Patients propose actions, become experts in their disease or in patients’ rights. This knowledge is exposed to medical students, in fields such as professional health communication, therapeutic education, shared decision-making, addictology. The teacher-patients make proposals for the evolution of the training towards other educational perspectives, they evaluate the students.
At the Francophonie Summit in Djerba (Tunisia) on November 19 and 20, 2022, which Emmanuel Macron attended, the international conference of French-speaking deans and faculties of medicine affirmed the urgency of tackling social inequalities in health and to conceive health in a logic of partnership. Citizens, elected officials and caregivers are enjoined to participate in the National Council for the Refoundation of the Health System. The sixth point of the national health strategy requires adapting training to the challenges of the health system. Rebuilding the system without thinking about the education of future professionals would be nonsense.
Dialogue between authorities and users
We call for radical changes. Medical training must be based on the concept of social responsibility in health. The territorial responsibility of the faculties of medicine, to meet health needs, must be declined at local and regional levels with the authorities (territorial professional health communities, etc.), in partnership with users. The tool for this participation must be a dialogue between authorities and users, with the aim of having quality health actors.
The training should question knowledge and power in the care relationship. This patient-teacher integration strategy must be sustainable. The challenge must not focus solely on educational strategies, but must offer a real vision, systemic and global, integrating societal changes on what the caregivers of tomorrow should be. Patients must be present within the faculties, at the level of the authorities, the places where “we decide and design”. The education code must be redesigned to give the patient-teacher a status, rights and remuneration.
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