title: [The patient--sufferer, partner or customer?].
abstract: Over the past two decades, physicians in the German healthcare system have been forced by economic and socio-political developments to accept a far-reaching dependence on non-medical interest groups. An increasing bureaucratic burden and decreasing incomes as the two most obvious signs of these changes have led to widespread unrest and dissatisfaction. Patients too have been assigned new roles. In addition to their traditional definition as "sufferers", they are now considered self-conscious customers and partners. The present paper discusses these changes focussing on the patient, thereby complementing earlier papers by the same author that have been published under the title "The Physician as a Stranger in Medicine- from driving to being driven". The perspective applied is that of a medical historian who regards the present as a product of the past. Medicine has always been asked to fulfil "demands". What is new is the nature of the "demands" that can be expected by customer-patients to be met by medicine. Furthermore, patients and not-yet-patients may constitute a pillar of future economic growth rather than a burden for a country's economy. Public health policy as well as the roles of physicians and patients are gradually adapting to these novel circumstances.
authors.affiliation: Horst-Görtz-lnstitut, Charité, Universitätsmedizin Berlin. unschuld@charite.de
authors.forename: Paul U
authors.initials: PU
authors.lastname: Unschuld
mesh_terms: D003695:Delivery of Health Care / Q000592:standards; D004645:Empathy; D005858:Germany; D006801:Humans; D010817:Physician-Patient Relations