The patient–doctor interaction has changed profoundly in the past decades. In reaction to paternalistic communication patterns, health policy makers have advocated for patient-centered care and shared decision-making. Although these models of medical communication remain still aspirational, patients have become more engaged in advocating for their own health in encounters with physicians. I argue that the engaged patient is a more accurate conceptualization of the changing role of the patient than patient consumerism, the empowered, or expert patient. I examine how the emergence of engaged patients influences the autonomy of health professionals, relates to the rise of the internet as an alternative source of medical information, centers the role of the patient–doctor interaction in public health epidemics, and contributes to health inequities.

在过去的几十年里，医患互动发生了深刻的变化。作为对家长式沟通模式的反应，卫生政策制定者提倡以患者为中心的护理和共享决策。尽管这些医学交流模式仍然令人向往，但患者在与医生会面时更加积极地倡导自己的健康。我认为，与患者消费主义、授权患者或专家患者相比，参与患者是对患者角色变化的更准确的概念化。我研究了参与患者的出现如何影响卫生专业人员的自主权，与作为医疗信息替代来源的互联网的兴起有关，以医患互动在公共卫生流行病中的作用为中心，并导致健康不公平。