Mundane patient and public participation in healthcare is more important than we tend to think

This article is about mundane participation by patients and the public in healthcare. I use this term to refer to their daily, nonstrategic, and free-flowing practices that at first glance may not seem participatory and yet can make crucial contributions to the functioning of healthcare. To discern how mundane participation can contribute to healthcare, I conceptualize its operation using the notion of network and fluid relations. This notion presents healthcare as a combination of (1) network relations , that is, fixed and explicit connections between elements, such as diagnoses, protocols, medical specialists, and insurance reimbursements, and (2) fluid relations , that is, temporary, tentative, and experimental linkages that allow for adjusting fixed arrangements to fit diverse health needs and improvising temporary solutions to healthcare problems. Drawing on the notion of network and fluid relations, I suggest that mundane participatory practices are directed at developing and experimenting with fluid relations and, thus, can instill flexibility into the operation of healthcare, allow for adaptations to specific circumstances, and promote open-ended learning. I propose that the ability of mundane participatory practices to produce these benefits makes them valuable and complementary to organized participation—explicit, clearly directed participatory activities with more structure, design, and boundaries—that have received more attention in practice and scholarship to date. Current efforts to improve patient and public participation in healthcare tend to overlook mundane participatory practices. This is problematic because such practices can help make our increasingly bureaucratized and technologically complex health systems work—and work well—amid uncertainties and pressures. By theorizing how mundane participation contributes to healthcare, this article provides a platform for advocating for a shift in how patient and public participation in healthcare is acknowledged and supported.