Patients can educate doctors about long term disease

Editor—Two fifths of both men and women reported having a longstanding illness.¹ The role of patients² in chronic disease is different from that of patients in acute disease. Patients with acute disease are usually happy to do what they are told and are generally cured and able to continue with their business. In chronic illness, however, the onset of the illness and subsequent diagnosis is often much slower. After diagnosis, treatment options are soon exhausted. With access to up to date information and research through the internet, patients are often better informed than their general practitioner about their condition.

People with a long term illness may at times conclude that the health service can no longer help. This naturally leads to frustration for everyone: doctors because they cannot do more and patients because they have to come to terms with living with reduced social and economic function. Part of the problem is that patients do not know how to make effective use of consultation time.

It does not need to be like this, however. If patients can attend courses that teach them the skills to deal with their symptoms through cognitive and behavioural exercises and learn the value of effective communication, including accurate self reporting of symptoms to their healthcare team, then a partnership can be formed which is both constructive and rewarding to both parties.

As someone who runs courses in the self management of chronic disease I have seen that those who attend courses wish for more of a partnership with their doctor and are often frustrated at the entrenched attitudes they encounter. Given the chance, patients are capable of managing their illness in partnership with their doctor. After all, it is they who wake up with it every morning.