Agency means one has the capacity to act on one’s own behalf with understanding.
It is the opposite of passivity.
It is the opposite of being carried along by systems or instructions without understanding.
Agency, when used concerning health, is the sense that your choices or opinion or objections deserve consideration, and that having them doesn’t mean that you should be dismissed as weird, or worse.
I think that most people want this; although they do not describe it as having ‘agency’.
They say things like ‘I want to understand what’s going on,’ or ‘I want to feel like I’m doing something,’ which express our underlying need that we want to be able to control or mitigate some of the outcomes that our body seems to be hurtling towards in an otherwise chaotic situation.
There are two problems with this.
Often there is the concept in the medical world that their way is the only ‘right’ way, and that if you defer from this that you are either lack sufficient intelligence, or you are a conspiracy theorist. I have had too many patients describe the eye roll of their medical professionals when they query the wisdom of injecting small babies with multiple vaccines, implying ‘here’s another crank’… or the sigh when you ask for the mechanisms of how eye drops for glaucoma works, and why does it increase the length of eyelashes…or waive them away they ask for a complete thyroid panel test and not just TSH.
I will concede that there are many medical professionals that would like to go into lengthy explanations, but they do not have the time to discuss every issues thrown up by social media built into their day.
Which brings me on the second problem.
Mixed in with much of the valid information online which gives evidence of, shall we say, alternative viewpoints to ‘conventional medicine’, they are waves of scams and false information being swept up with the useful and correct guidance. Specific vitamins, or minerals, that cure all sorts of health issues; real snake oil stuff. Or adverts that start off with what you think is a moving personal testimony of how this lovely person talking to you had tried this and that for something troubling, and then she tried a specific supplement and then…you realise it is another advert. A scam.
Apart from the ‘if you buy this particular salve made in the Arctic circle you will cure your psoriasis’ there may well be an approach worth listening to, but it is drowned in all the noise.
How do we tell?
Firstly, if it slashes prices from £395 to a one-time offer of £27, with a time limit of JUST TODAY, I would walk on by…
Secondly, find health professionals online who have a long track record and don’t promote themselves or one specific product [Dr Rangan Chatterjee is one – he has had a lot of interesting people on his podcast who have discussed possible routes to health which bypass the drug route (Dr Chris Palmer is one)].
Thirdly, avoid adverts and/or people that proclaim that THEIR approach is the only one that works.
The fact is though, that sometimes there is so much deference given to modern medicine, coupled with the traditional respect that doctors have been blessed with, that patients may feel that their GP can do no wrong and must be ‘obeyed’.
One of my patients said her in-laws would come out of the Pharmacy with carrier bags of medications that had never helped their health conditions over many years. When she asked why they kept taking them if they did not help, they answered, ‘the doctor told us to’.
I had a patient who had been on Omeprazole daily for 10 years. I told her that was too long to have been receiving that prescription and asked if it had resolved her reflux. She said she had never had reflux. I asked why her GP had prescribed her Omeprazole then, she said she didn’t know. I asked her why she kept taking it, she said, ‘the doctor told me to’.
This is the real loss of agency, when people are processed through systems that prioritise efficiency over understanding. They are given instructions, not explanations. They are told what to take, not why it might help. Or maybe they don’t feel the need to know?
But in my experience, giving patients agency also changes behaviour. When people understand why a medication helps them, they use it differently. They notice when they need it and when they do not. They adjust their routines. They make dietary changes that support the same physiological pathways. They become more observant of triggers and patterns.
This is not compliance; it is participation. And it should be the goal of every patient to treat their health journey in this way.
credit for wiki photo; https://commons.wikimedia.org/wiki/User:W.carter
