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Paternalistic approaches to care, which emerged between the 1940s and 1970s from medicine that gradually became all-powerful within health systems structured around acute and highly specialized care offered in health facilities, were gradually combined, or even replaced, to meet the needs of populations.

They are the result of epidemiological mutations, such as the significant increase in the prevalence of chronic diseases and aging populations. They have thus gradually given way, since their timid beginnings in the 1970s, to patient-centered approaches. These take into consideration the particularities, values and experiences of patients.

All over the world, healthcare organizations, institutions and universities have gradually redoubled their efforts to involve patients and make their participation increasingly active, in very different ways and with very different motivations. Recent initiatives, such as shared decision-making, have added to the diversity of approaches in therapeutic patient education (TPE). Then, starting at the University of Montreal at the beginning of the second half of the 20th century, a new approach emerged under the term “partnership approach”; it is a partnership of care with the patient, otherwise known as the “Montreal model” by the Americans since the workshops conducted in 2014 under the aegis of the Macy Foundation.

Thus, there is currently a continuum of models for mobilizing patient and population empowerment (Figure 1.1); it includes access to information for patients and populations, their contribution to all stages and strata of care, their involvement in healthcare organizations through participatory modalities that go as far as co-construction and co-design between patients and healthcare professionals (Pomey et al. 2015).