ABSTRACT
In this chapter, some of the factors that may have steered us to the current situation in which inappropriate health care is commonplace instead of being a rare phenomenon are considered. One of the major contributors to our current unsatisfactory situation has been our allegiance to the Western biomedical model of science. In many ways, the scientific enterprise has come to be cherished above all else with an overuse of reductionist thinking and the lure of the commercial imperatives of product development driving suboptimal care in many cases. Research must focus on the things that are of most concern to the people who will be the ultimate beneficiaries of the results of the research. Our subservience to the biomedical model has resulted in an almost exclusive focus on correcting deviations from biological norms instead of helping patients meet important needs. In moving towards an era of health care in which patient perspectives authentically steer service provision, the power imbalance may be one of the first issues to address. Patient-centred health care has failed, and it is imperative that a new age of health care begins in which the cornerstone of appropriate care is the perspective of the patient.
