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Men's Healthcare Q1 2023

Modern medicine and care require a paradigm shift with more patient engagement

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Prof. Eamonn Rogers

Chairman, EAU Patient Office

Patient engagement interventions save lives. Effective communication between urologists and their patients is vital to improving treatment outcomes and long-term patient quality of life.


Patient engagement will revolutionise medicine. That was the message at the Patient Day of the biggest urology congress in Europe. There is new scientific evidence proving that involving patients in the decision-making process of treatments will improve outcomes.

Aspects like quality of life, anxiety, depression and fatigue are often neglected but deserve more attention in the treatment of urological patients. However, the subject demands greater attention, and additional research is required.

Both medical experts and patients need to recognise that contemporary patient advocacy must take a comprehensive and holistic approach, encompassing not only direct support for patients but also guidance for research initiatives and influence over the healthcare and regulatory policies that affect patients’ lives.

Hierarchical nature of healthcare

To help understand where patient-physician communication breaks down, social psychologist Tamás Bereczky points to the hierarchical nature of healthcare and how that facilitates barriers to functional patient-physician communication. The healthcare system often places doctors on the top of a hierarchy, while patients are often ‘reduced to a number or a line on an Excel sheet.’ This creates a system of epistemic injustice, as the patient’s experience can be invalidated based on their hierarchical status.

Best practices should include tackling
paternalistic and hierarchical approaches,
educating both physicians and patients,
limiting jargon and using empathy.

Best practices for physicians and patients

With regard to the dichotomy of clear evidence versus slow changes within the medical field, experts need to understand how fundamental these issues are to medicine and how the change needs to be systematic.

According to Bereczky: “It’s a paradigm shift, and that takes time.” Best practices should include tackling paternalistic and hierarchical approaches, educating both physicians and patients, limiting jargon and using empathy.

Instead of only considering ‘hard’ outcomes — like time limits and financial constraints — healthcare professionals should include soft outcomes in their choice for treatment, like a patient’s emotional state and understanding of their medical situation. This fundamental issue needs to be tackled early on in specialists’ medical journeys, potentially starting with training in medical school, with more research and specific, clear guidelines targeting patient education and communication.

Especially when it comes to men’s health issues, male patients are often more reluctant to discuss these softer topics than female patients. So, it is not only a matter of teaching young doctors about the importance of communication but also making male patients aware that talking about their mental health will improve their outcomes.

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