We need another word for ‘chronic’

Is it time to stop using the word ‘chronic’ and talking about chronic disease? The BJGP in December has the reference to chronic in the title of four of its articles.^1–4 Language changes with time and with usage. For example, the phrase ‘terminal care’ has made a transition to the more positive-sounding ‘palliative care’, not least because we are far more open in our discussions with patients than we were a generation or two ago and need to be sensitive to their interpretation of our terminology. Similarly, doctors may understand the term chronic in its primary dictionary sense of ‘persisting for a long time or constantly recurring’ and so may the some of the public.⁵ But others are more likely to hear its secondary, informal meaning ‘of a very poor quality’ and be offended, frightened, or bemused by this label being attached to their disease or, worse still, to their general health?

As we revise our curriculum at Nottingham we hope to incorporate further student experience that is community based with patients who have single morbidity or multiple comorbidities. Our debate is not over the urgent need for such education with population demographics changing to an increasingly older population, but what we call it, rather than chronic disease. Could it be: long-term conditions; integration of care in complex disease; integrated care; managing complex conditions; community-based disease; advanced primary care; living with long-term illness, or another new entity? Whatever term is adopted, it should be more optimistic and evolve from a discussion between disciplines and with patient participation groups.