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The patient role has been discussed in western health systems literature for decades. In this discourse analysis, based on the work of the French philosopher Michel Foucault, we analyzed a broad selection of Danish materials in the field of healthcare. We found that patient involvement is a discursive ideal. The ideal is anchored in implicit assumptions about the characteristics and capacities that the patient is expected to acquire and display: the patient must be active, knowledgeable, a competent decision-maker, obtain insight into own disease, and have supportive relatives. To achieve the ideal of patient participation we suggest that there is a need for a certain type of active patient; otherwise patient involvement plans cannot succeed. We identified a single discursive strategy in which the patient was attributed the role of being actively involved by addressing the patient’s characteristics, skills, desires, actions and expectations. Finally, we discussed how this patient role could actually increase health inequality despite intentions to the contrary.

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