It may come as a surprise to some to know the former commissioner does not expect them to be paragons.
He would, however, like us patients to be able to get a better idea if our doctors are "good enough".
"I want to know that even the ordinary practitioner meets minimum standards, and is someone whom I, and my family, can safely consult," Prof Paterson writes.
In The Good Doctor: What patients want, he accepts that about 95% of the country's 12,000 doctors provide an appropriate standard of care, but suggests about 600 may not be good enough. A "very small group" of these "subpar" doctors could be potentially dangerous and unfit to practise.
He points out the difficulty is we do not know where the bar is because of the lack of agreed standards in many areas, and how many doctors may be falling below it. It is hard to get much information at all about our doctors, let alone anything that might help us decide whether they are up to scratch.
"I find it unacceptable that, within the medical community, it is often common knowledge that a certain doctor should be avoided for the care of one's own family, but that the general public is not privy to such information."
In his book Prof Paterson, now a professor of health law and policy at Auckland University, considers what patients want in a doctor, explores some of the instances involving problem doctors both here and overseas, looks at the adequacy of existing checks on competency, and the difficulties of changing to a system that could assure us about good doctors. He finishes with his prescription for change. It is a clearly written, easily accessible and often fascinating exploration of a subject that is more complex than many might realise.
Barriers to change, Prof Paterson says, include undemanding patients, overburdened doctors, reluctant regulators and legal restraints, but he considers the greatest obstacle is the culture of medicine or "the way we do things around here".
He is critical of doctors' reluctance to judge the errors of colleagues and their denigration of those who might provide independent advice to inquiries, using instances from his own experience.
"My concern here is that the denigration of experts reinforces a 'closed shop' reluctance to advise an inquiry on standards of care. Why rock the boat by criticising one's peers (who are almost invariably not identified in the published investigation report, unlike the expert advisers) and risk public censure oneself?"
Change is possible. Prof Paterson's research into information available in other countries shows publication of surgeon-specific cardiac outcomes data in the United States and United Kingdom resulted in a 40% drop in risk-adjusted deaths. Importantly, this was achieved without denying surgery to high-risk patients. The UK initiative for this was spurred by a quest to find out how many patients were dying in hospital from cardiac surgery and to understand reasons for any variations.
Of course it was not easy to develop appropriate criteria to ensure comparisons were fair, and there was initial resistance including fears of sensationalist media reporting.
But better data collection, analysis and follow-up led to potential problems being detected earlier, as well as fewer suspensions or restrictions on doctors' practice. The initiative turned out to be "good for patients and doctors".
Broadly, Prof Paterson's proposed improvements involve ways to provide patients with better information about doctors and their practice, better recertification processes for doctors, and regulatory reform to provide more proactive, independent and transparent oversight with increased input from lay members.
Hopefully, his thoughtful and reasoned approach to the issues he raises will lead to a lively and constructive debate rather than an epidemic in the health sector of those uncomfortable medical conditions - knee-jerk reaction and head-in-the-sand syndrome.
• Elspeth McLean is a columnist and former health reporter for the Otago Daily Times.
