ABSTRACT
Patient-centered prescribing requires the clinician to believe that this is the preferable way to provide care, and that it is morally correct, rather than a way of creating compliance, as patients may make decisions with which the clinician disagrees. There is emerging evidence that patient care improves when choices are genuinely offered, but at present there is only tentative evidence that health outcomes improve, and it must be recognized that this is to some extent a leap of faith. Probably the most common marker of discordance is so-called non-compliance, particularly if it appears that clinical care is suboptimal as a result. Other examples include divergent beliefs about the disease or illness course, or a substantive cultural divide between clinician and patient. Professionals such as nurses and pharmacists can have a crucial bridging role, providing an opportunity for patients' concerns and doubts to be formulated and expressed.
