Conceptualizing lay participation in professional health care organizations

The participation of lay people in health care decision-making lacks an adequate analysis from an organizational perspective. This article aims to develop conceptual devices to analyze policies and practices and to discuss ways in which these policies and practices could be further developed. By recapping established frameworks and drawing on theories of professional organizations, four roles for the participation of lay people and their potential to adapt organizational decision processes to internal requirements and external challenges are elaborated. While individual patient participation is widely acknowledged, there is still a lack of systematic approaches to the roles of significant others, patient groups and the broader community and their implementation within health care organizations.