The rise of the professionalising patient

In this chapter the increasing importance of patient self-management and public engagement in supra-state and state healthcare policies is explored, focusing on the United Kingdom. Using a neo-Weberian and neo-institutionalist framework, it is argued that these policies have given rise to the ‘professionalising patient’, reconfiguring healthcare governance and impacting traditional professional authority in the healthcare professional–patient encounter. The contested sociological meanings of ‘lay expertise’ and the healthcare professional–patient encounter in an increasingly consumerist and technological context is considered, along with a discussion of the challenges they pose to implementing global patient engagement policies. As regulatory systems increasingly advocate the institutionalisation of the patient in healthcare, the competing logics at play and the potential for overlooking the complexities of local implementation of these policies are also noted, particularly in relation to the healthcare professional–patient relationship. It is concluded that the level of patient professionalisation is likely to vary due to socio-economic, cultural and systemic differences and will therefore impact traditional professional dominance differently, depending on context. Global patient engagement policies need to consider this complexity.