An end to the "muffin meeting": Conceptualizing power and navigating tokenism in patient engagement for health leaders.

Patient engagement is emerging as a priority for Canadian health leaders. Alongside the proliferation of patient engagement efforts in healthcare organizations and networks, awareness that tokenism can potentially occur within such efforts, as well as strategies to mitigate it, are gaining increased attention. While many actions associated with more tokenistic forms of patient engagement have been identified, this article posits there is a need to pay critical attention to the concept and role of power in enabling these actions in the first place. Of particular importance is how power and knowledge work to shape healthcare organizations and can create unequal relations with the patients they seek to engage. Drawing on the literature, this article serves as a theoretical roadmap for health leaders to think critically about power, as well as a set of prompts that can be used to reflexively consider their role in navigating power dynamics in the context of patient engagement efforts. This article contends that building awareness of power is a critical step for health leaders and organizations and that navigating power differences is a necessary leadership competency for engaging patients in decision-making throughout all stages of healthcare improvement and organizational change efforts.