“Liberté, égalité, santé!”

libertyLife in 18th century France was probably far from easy, although less difficult for some. The aristocracy were living relatively comfortable lives, where the very small minority were enjoying privileges that the large masses could only dream of. In fact, they couldn’t even dream there was such privileges. And we all remember the allegedly immortal words of the well-meaning but clueless Marie Antoinette: “But if the people don’t have bread, why don’t they eat cakes?”.

I would guess that the aristocracy didn’t really understand what the fuss was all about: “Why are these people upset? We have always taken care of them. We know what is best for them. They don’t need to worry their heads with the problems of the world, they are not even interested anyway…”. And we know what happened: the aristocracy didn’t  have to worry about haircuts ever again…

That attitude feels strangely familiar… And sure, with more rights comes more responsibilities. The right to vote is still not universal, and in Sweden, women didn’t have the same rights to vote as men until 1919. I don’t know about you, but in my opinion, my health is more important to me than who is the prime minister in Sweden (sure, the two are not independent but still).

People often tell me: “But Sara, you have to remember that not all patients are as engaged as you, you are an outlier…” My response is always: “I know that I am an engaged, knowledgable autonomous patient now, but 7 years ago I wasn’t, I was just an ordinary patient.”

The French Revolution, The Suffragett Movement and the Anti-apartheid Movement were all started by outliers. The masses were probably not very interested in what they were shouting about, they just wanted to do their best of a difficult situation… at first…

In my opinion, large parts of healthcare’s logic is based on the assumption that the doctor always knows best. And we patients have accepted that assumption for centuries, but times are changing.

We want to take more responsibility when it comes to our health!

The world cannot afford letting patients’ engagement and knowledge be wasted any longer!


  1. I too have long felt that the issue of patient-professional partnership is an issue of social justice, but I often struggle with how to communicate that and whether the argument is actually a more or less effective rhetorical tool than say, connecting to outcomes, cost, equity (across patient populations, not in general) or quality. In my heart, I know why I work for change, but I don’t know that it makes for a persuasive argument in professional circles. What do you think?

    1. Cristin, the issue is as we know very complex and I don’t think there is only one answer. In my experience, the best case is built from a combination of being personal and professional. It’s not easy, but we know it’s worth it, right? 🙂

  2. Yes, this also shows in the way many doctors dismiss proposals for ehealth services with the classic top-down argument “old patients cannot use computers and smartphones, and they would be unnecessarily worried if they have access to their health data”.
    I say: Let the patient’s themselves decide if they want to use ehealth Services! Besides the enormous health benefits and cost savings this will also enable better resources to support the minority that need 100% hands-on support.

  3. It was so inspiring to hear you talk at Dagens patient last Monday! I work full time with with MS as my companion. I recognise the transformation you’ve been through – from an “ordinary patient” to a very engaged impatient patient. I’m right behind you 🙂

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