The challenge of lay partnership

Abstract

Lay people have long been involved in the health service as members of governance bodies and other committees. But only recently have they been involved at the heart of professional practice and performance, working with doctors in doctor-patient groups discussing standards and guidelines, audit and revalidation. This involvement challenges doctors' belief that they can decide by themselves what patients' interests are and how they should be met. Yet when they accept this challenge and work with lay people as equals the scene is set for productive work. For such partnership to work well we must be clear what “lay” means. Doctors share core values, norms, and skills but specialise in various ways and to different levels. Parallels among lay people are less well understood. Some lay people, usually after being a patient, develop expertise in the experiences, perceptions, and interests of patients as patients define them. These, not “ordinary” lay people, are the ones who should take part in doctor-patient groups. Among them, too, are variations in knowledge.1 Patients' expertise lies in the immediacy and detail of their own experiences of health care. They cannot usually speak for other patients, partly because they seldom know …