Are health professionals supermarkets and their patients customers in a commercial transaction? If so, what scope is there for refusing their customers’ demands? This week’s editorial in The Lancet indignantly rejects the consumer model being proposed by the UK’s Chief Medical Officer, Liam Donaldson.

In an interview in the London Times Dr Donaldson recently compared the British National Health Service to a supermarket chain. “I once heard Terry Leahy of Tesco saying that customer feedback was hard- wired into Tesco,” he said. “I think patient feedback should be hard-wired into the NHS because it is absolutely vital.”

This provoked The Lancet to complain bitterly that medical care is being undermined by “the emphasis on a patients’ complaints culture”. Doctors may have been too paternalistic in the past, “But does this mean that patients as consumers should lead, and that doctors and health-care systems should merely follow?” “Naked consumerism will not lead to better health,” thunders the editorial.

Oddly enough, while British medicine is allegedly being subverted by consumerism, the American Medical Association appears to be embracing it. In June its annual conference declared that pharmacists were obliged to ensure that prescriptions for the morning-after pill be filled. “The AMA strongly believes patients have to have access to their medications. It’s the obligation on behalf of the pharmacist… to tell them where to go,” said AMA board member Dr. Peter Carmel.