In its special summer edition, the independent French medical journal La revue Prescrire has published a collection of texts that is both light-hearted and serious, challenging healthcare professionals to think about the "fundamentals" of their practice.

To deliver the best care, it is important to maintain freedom of thought and of action. And to that end, to enlarge one's field of vision, to take a step back and look at all sources of information, in order to choose the most reliable: What interests are at play? How was the information produced? What is the level of evidence? What guarantees its reliability? What guarantees its relevance as a basis for better care?

Choosing one's sources of information and knowing how to interpret medical information deserves to be recognised as a "fundamental" medical discipline, just the same as anatomy or cell biology.

For their continuing medical education, healthcare professionals need to sort through information, and single out that which is based on high-quality criteria. Understanding how the people who provide this information work, and remaining critical and self-critical, is in turn useful for quality decision-making in healthcare.

Whatever a healthcare professional's beliefs may be, the patient's choice is sometimes different. And in this case there is room in the relationship between patient and healthcare practitioner for discussion and compromise, without going against the patient's interests.

Being able to adapt prescriptions to patients' characteristics and wishes, even when that may mean departing from theoretically more desirable measures, is a quality in a healthcare professional. And it necessitates, with each well-informed patient, estimating the benefit that can be expected and the harm that may result. And finding the limits of acceptable compromise, beyond which it is better to say no. And then to re-evaluate the situation later on.

©Prescrire 1 August 2016

"Bâtir des relations de soins : Une randonnée par étapes" Rev Prescrire 2016; 36 (394). View the table of contents (Free, in French)