[Toward new approaches to quality. The patient as coprotagonist. 2008 SESPAS Report]

In recent decades, the doctor-patient relationship has been decisively transformed, reflecting social developments in health care and the rise of individual rights in our society. This article briefly reviews how this change has been reflected in the legal and social framework, how it affects the doctor-patient relationship, how health services should adapt to this new reality, which changes are predictable, or desirable, and how health services are currently responding. The model of healthcare should adjust to the new role played by patients, requiring quality control of the information accessed - available in different formats and from distinct sources - and new attitudes and skills of health professionals and patients. The development of a homogeneous information system throughout the Spanish national health service is required. This information system should address a minimum number of key indicators and outcomes. The dissemination and analysis of these indicators and outcomes is a pressing need, not only as a comparison tool, but to identify and disseminate good practices.