Abstract
There has been a lack of discussion and consensus as to what the role of the general practitioner should be in the care of patients with chronic diseases. Should general practitioners concentrate on the disease or should their remit include the resultant disability and handicap? General practitioners have tended to concentrate on the disease, but this may be inappropriate. For many disabled people, their general practitioner is their only source of health care and is the gatekeeper to other services. Greater knowledge among doctors of the functional and social aspects of disease would therefore improve the quality of care for patients, and should be assessed through clinical audit. Ways are described in which general practitioners, working together with their patients with chronic diseases and with other health professionals, can improve aspects of the care of these patients.
Full text
PDF![109](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c4/1239542/d27d435cf12e/brjgenprac00011-0057.png)
![110](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c4/1239542/ea9c9c711852/brjgenprac00011-0058.png)
![111](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c4/1239542/041441d448e4/brjgenprac00011-0059.png)
![112](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c4/1239542/712e8c9fabc1/brjgenprac00011-0060.png)
![113](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02c4/1239542/9036b121ab2c/brjgenprac00011-0061.png)
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bury M. Chronic illness as biographical disruption. Sociol Health Illn. 1982 Jul;4(2):167–182. doi: 10.1111/1467-9566.ep11339939. [DOI] [PubMed] [Google Scholar]
- Chesson R. A., Sutherland A. M. General practice and the provision of information and services for physically disabled people aged 16 to 65 years. Br J Gen Pract. 1992 Nov;42(364):473–476. [PMC free article] [PubMed] [Google Scholar]
- Cooper G. L., Huitson A. An audit of the management of patients with epilepsy in thirty general practices. J R Coll Gen Pract. 1986 May;36(286):204–208. [PMC free article] [PubMed] [Google Scholar]
- Engel G. L. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980 May;137(5):535–544. doi: 10.1176/ajp.137.5.535. [DOI] [PubMed] [Google Scholar]
- Freeling P., Rao B. M., Paykel E. S., Sireling L. I., Burton R. H. Unrecognised depression in general practice. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1880–1883. [PMC free article] [PubMed] [Google Scholar]
- Freeman G. K., Richards S. C. Personal continuity and the care of patients with epilepsy in general practice. Br J Gen Pract. 1994 Sep;44(386):395–399. [PMC free article] [PubMed] [Google Scholar]
- Harper A. C., Harper D. A., Chambers L. W., Cino P. M., Singer J. An epidemiological description of physical, social and psychological problems in multiple sclerosis. J Chronic Dis. 1986;39(4):305–310. doi: 10.1016/0021-9681(86)90052-4. [DOI] [PubMed] [Google Scholar]
- Hasler J. C. James Mackenzie lecture. The very stuff of general practice. J R Coll Gen Pract. 1985 Mar;35(272):121–127. [PMC free article] [PubMed] [Google Scholar]
- Jones K. P., Bain D. J., Middleton M., Mullee M. A. Correlates of asthma morbidity in primary care. BMJ. 1992 Feb 8;304(6823):361–364. doi: 10.1136/bmj.304.6823.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones K. P., Charlton I. H., Middleton M., Preece W. J., Hill A. P. Targeting asthma care in general practice using a morbidity index. BMJ. 1992 May 23;304(6838):1353–1356. doi: 10.1136/bmj.304.6838.1353. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirwan J. R., Reeback J. S. Stanford Health Assessment Questionnaire modified to assess disability in British patients with rheumatoid arthritis. Br J Rheumatol. 1986 May;25(2):206–209. doi: 10.1093/rheumatology/25.2.206. [DOI] [PubMed] [Google Scholar]
- MacLennan W. J. Screening elderly patients. BMJ. 1990 Mar 17;300(6726):694–695. doi: 10.1136/bmj.300.6726.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Patrick D. L., Peach H., Gregg I. Disablement and care: a comparison of patient views and general practitioner knowledge. J R Coll Gen Pract. 1982 Jul;32(240):429–434. [PMC free article] [PubMed] [Google Scholar]
- Williams S. J., Bury M. R. Impairment, disability and handicap in chronic respiratory illness. Soc Sci Med. 1989;29(5):609–616. doi: 10.1016/0277-9536(89)90180-9. [DOI] [PubMed] [Google Scholar]
- Wood P. H. The language of disablement: a glossary relating to disease and its consequences. Int Rehabil Med. 1980;2(2):86–92. doi: 10.3109/09638288009163963. [DOI] [PubMed] [Google Scholar]