There is a curious contradiction at the heart of modern medicine. Patients are constantly told to take responsibility for their health, become informed consumers, understand the risks of treatment and participate in medical decisions. Yet when some patients take this advice seriously, read medical research, question a diagnosis or challenge a proposed treatment, they may discover that their intellectual independence is considerably less welcome than the official rhetoric suggests. The ideal patient, it sometimes seems, is informed enough to obey instructions but not sufficiently informed to dispute them.
Clinical psychologist Roger McFillin, writing in The Defender on November 3, 2026, raises this problem in a provocative article entitled "Patients Who Ask Questions Have a Psychological Disorder, Medical Establishment Tells Doctors." His immediate target is a Medscape discussion of why patients sometimes trust unsupported medical claims more readily than their own physicians. McFillin argues that the medical profession increasingly approaches patient scepticism as a psychological or communication problem to be corrected rather than an opportunity to examine the evidence underlying medical recommendations.
The headline is deliberately provocative, and it would be an exaggeration to suggest that the medical profession has officially classified ordinary questioning as a psychiatric disorder. Nevertheless, McFillin identifies a genuine danger. Once disagreement with medical authority is interpreted primarily through the psychology of the dissenter, the substance of the disagreement can disappear from consideration. The patient asks whether a treatment is necessary, whether the evidence is convincing or whether the benefits justify the risks. Instead of receiving a detailed answer, he may encounter an explanation of why people are vulnerable to misinformation.
This is a familiar intellectual manoeuvre, extending far beyond medicine. Rather than answering a criticism, an institution explains why the critic has come to hold mistaken beliefs. The disagreement is relocated from the evidence to the supposed deficiencies of the person raising it. In medicine, where the professional possesses considerable authority and the patient may be vulnerable, such an approach is particularly troubling.
Of course, medical misinformation is real. Patients can encounter false claims online, misunderstand research findings or become convinced that ineffective treatments offer miraculous cures. Doctors have legitimate reasons to correct such errors. But it does not follow that every challenge to professional advice is misinformation, or that the correct response to scepticism is a programme of psychological persuasion. The distinction between correcting a factual error and securing obedience to authority is fundamental.
The problem becomes more serious when we consider the scale of harm associated with medical treatment itself. The World Health Organization has estimated that approximately one in ten patients experiences harm during healthcare, with more than half of such harm considered preventable. It also estimates that unsafe care contributes to more than three million deaths annually worldwide. These are not figures invented by anti-medical activists. They come from one of the world's principal international health authorities.
The WHO identifies medication errors, unsafe surgical procedures, healthcare-associated infections, diagnostic mistakes and other failures as important sources of patient harm. Its findings demonstrate that modern healthcare, notwithstanding its extraordinary achievements, remains an enterprise in which mistakes can have devastating consequences. The same institution that saves lives can also injure or kill through preventable failures.
The Organisation for Economic Co-operation and Development has similarly identified patient safety as a major problem, estimating that a substantial proportion of healthcare expenditure is associated with treating harm arising during care. Such findings should encourage humility throughout the medical profession. A system capable of causing extensive unintended harm has every reason to welcome careful scrutiny from patients, independent researchers and critics.
It is important to distinguish adverse medical outcomes from negligence. Not every complication is avoidable, and many treatments carry risks that are justified by their benefits. Serious illnesses can produce poor outcomes even when physicians act competently. Nevertheless, preventable harm is sufficiently widespread that the medical profession cannot reasonably claim immunity from sustained criticism. Indeed, its own patient-safety literature provides some of the strongest evidence for the necessity of such scrutiny.
This leads to a question rarely confronted in public discussions of medical misinformation. If the consequences of incorrect medical advice can include permanent disability or death, why should patients be discouraged from examining the evidence upon which that advice rests? The greater the potential harm, the stronger the justification for independent questioning.
The issue is particularly relevant to general practice, where many patients first encounter the medical system. General practitioners occupy a position of considerable responsibility, often making decisions under intense time pressures and with incomplete information. Many are conscientious professionals who welcome discussion and recognise the limits of their knowledge. Others may respond defensively when patients question a diagnosis, request additional tests or present research that challenges an initial assessment.
Such defensiveness is understandable at a human level but remains professionally problematic. Doctors are subject to the same psychological tendencies as everyone else, including confirmation bias, overconfidence and resistance to information that threatens an established judgement. Medical qualifications do not confer immunity from ordinary human error.
A patient who questions a diagnosis may be mistaken. But the doctor may also be mistaken. The entire purpose of rational discussion is to determine which interpretation is better supported by the evidence. Treating professional status as sufficient to settle the matter substitutes hierarchy for reasoning.
There is an additional difficulty in the growing complexity of contemporary medicine. Medical knowledge has expanded beyond the capacity of any individual practitioner to master comprehensively. Research findings change, clinical guidelines are revised and treatments once considered beneficial may later prove ineffective or harmful. The history of medicine contains numerous examples of interventions that were widely accepted before subsequent evidence led to their abandonment or restriction.
The opioid prescribing crisis provides a particularly sobering example. In the United States, the aggressive promotion and extensive prescribing of opioid painkillers contributed to widespread dependence, addiction and overdose deaths. Regulatory failures, commercial incentives and mistaken assumptions about addiction risk all played important roles. The catastrophe illustrates the danger of confusing prevailing medical practice with established scientific truth.
Medical history also offers the example of hormone replacement therapy. For years, observational evidence encouraged enthusiasm about possible cardiovascular benefits for some women. Large randomised trials subsequently challenged important aspects of that understanding, leading to substantial changes in prescribing practices. Later research produced a more nuanced assessment, distinguishing different treatments, patient groups and risks. The lesson is not that hormone therapy is inherently bad, but that medical confidence must remain proportionate to the strength and limitations of available evidence.
Medicine advances partly by discovering that earlier medicine was wrong. This should be a source of intellectual humility rather than embarrassment. Scientific progress depends upon criticism, replication, revised hypotheses and the willingness to abandon attractive theories when they conflict with evidence.
Yet modern medical practice operates within institutional structures that can make such humility difficult. Professional guidelines, regulatory bodies, pharmaceutical companies, hospital administrations, insurers and government agencies all influence the conditions under which doctors work. Clinical decisions are not made in an intellectual vacuum. They occur within systems of financial incentives, legal obligations, professional expectations and bureaucratic procedures.
This does not mean that medical guidelines are worthless or that pharmaceutical research is necessarily corrupt. Standardised guidelines often improve care, and modern medicines have prevented immense suffering and premature death. But institutional arrangements can create conflicts of interest and pressures towards conformity. When guidelines become substitutes for independent clinical judgement, there is a danger that the individual patient disappears behind an administrative category.
The commercial dimension deserves particular scrutiny. Pharmaceutical companies are profit-seeking organisations whose financial interests do not always coincide perfectly with the interests of patients. This is why independent trials, transparent reporting, regulatory oversight and disclosure of conflicts of interest are essential. The existence of a financial incentive does not establish that a treatment is ineffective, but neither should commercial sponsorship be regarded as irrelevant to the evaluation of evidence.
Patients are entitled to ask whether a treatment has been adequately tested, whether its benefits are clinically meaningful, what adverse effects have been documented and whether less invasive alternatives exist. These are not eccentric questions. They are central to rational medical decision-making.
Indeed, the principle of informed consent becomes almost meaningless if questioning is treated as an obstacle to be overcome. Consent is not merely a signature on a form or a verbal expression of agreement. It requires that patients understand the material risks, likely benefits and reasonable alternatives to a proposed intervention. They must also be free to refuse treatment without being subjected to inappropriate pressure.
A patient who asks why a medication is necessary, whether a condition might resolve without intervention or whether a second opinion would be useful is exercising precisely the kind of autonomy that modern medical ethics claims to respect. If such questions provoke hostility, the failure lies not in the patient's curiosity but in the breakdown of the professional relationship.
The question of trust is particularly important. Medical authorities frequently express concern about declining public confidence, especially following the controversies surrounding COVID-19. But trust cannot simply be demanded as a professional entitlement. It must be earned through competence, transparency, honesty and a demonstrated willingness to acknowledge uncertainty.
The pandemic revealed the difficulty of communicating medical evidence during a rapidly developing emergency. Scientific understanding changed as new information became available, while governments and public-health authorities faced pressure to issue clear recommendations despite uncertainty. Some changes in advice reflected legitimate scientific progress. Others exposed communication failures, excessive confidence or the tendency to present provisional judgements as settled conclusions.
The appropriate lesson is not that all public-health advice should be rejected. That would be an irrational response to institutional fallibility. Rather, the lesson is that public confidence is strengthened when authorities distinguish established knowledge from uncertainty, acknowledge errors and explain the reasoning behind their recommendations.
McFillin is particularly critical of attempts to psychologically prepare patients to reject misinformation before encountering it. Such techniques, sometimes described as psychological inoculation, have legitimate applications in helping people recognise misleading arguments. But their use in medical communication raises an important ethical question. Are patients being equipped to evaluate evidence independently, or are they being encouraged to accept a predetermined institutional position?
The distinction depends upon how the technique is employed. Teaching patients to recognise fraudulent claims, fabricated studies or misleading statistics can improve their ability to make informed decisions. But teaching them to dismiss criticism merely because it challenges official recommendations would undermine the very intellectual independence that informed consent requires.
The problem is not persuasion itself. Doctors routinely and properly attempt to persuade patients when strong evidence supports a particular course of treatment. The problem arises when persuasion becomes detached from open examination of the evidence and turns into an exercise in securing compliance.
A good physician should be able to explain not only why a treatment is recommended but also what evidence might justify changing that recommendation. He should be prepared to discuss uncertainty, competing interpretations and the possibility of error. This is not a demand for endless debate over every internet claim. It is a demand that professional authority remain accountable to reason.
There are practical limitations, naturally. A busy GP cannot spend several hours examining every paper a patient brings into the consulting room. Some patients may be confrontational, and some may insist upon treatments that are ineffective or dangerous. Doctors are entitled to exercise professional judgement and decline inappropriate requests. But time constraints and professional boundaries do not justify contempt towards reasonable questions.
Nor should legitimate psychological conditions be confused with ordinary scepticism. Health anxiety and other disorders can involve distressing patterns of excessive reassurance-seeking, but they cannot be diagnosed simply because a patient challenges medical advice. A person can be anxious and correct, sceptical and mistaken, or confident and profoundly misinformed. The truth of a medical proposition must be evaluated independently of the personality of the person expressing it.
The medical profession's own recognition of preventable harm should make this principle uncontroversial. Diagnostic errors, medication mistakes and failures of communication are not hypothetical dangers. They are documented problems with consequences for millions of patients. Independent questioning can sometimes help identify mistakes before they become tragedies.
Indeed, the WHO explicitly recognises patient engagement as an important component of safer healthcare. Patients and families can provide information that clinicians overlook, identify inconsistencies in treatment and contribute to the detection of errors. A culture that discourages questioning may therefore undermine patient safety rather than protect it.
The central problem is the persistence of medical paternalism beneath the language of patient empowerment. The patient is officially celebrated as an active participant in healthcare, but may still be expected to defer when professional authority is challenged. The contradiction becomes most visible when a patient is encouraged to become informed, only to discover that his information is unwelcome because it comes from outside the approved institutional hierarchy.
Ultimately, the scale of preventable medical harm makes the case for critical scrutiny overwhelming. A profession whose decisions can determine whether people live, die or suffer permanent injury must be held to especially demanding standards of accountability.
Roger McFillin's criticism therefore raises a question that reaches to the foundations of medical ethics. Does modern healthcare genuinely want informed patients, or does it prefer compliant patients who have been taught to regard institutional authority as the final word?