System needs managing better

EDITOR—With reference to Wagner's editorial on meeting the needs of chronically ill people, many doctors should remember that patients with chronic diseases are not always socially deprived, are often articulate when their condition is not debilitating their cognitive function, and cannot help being ill.1 Depression is more often brought on by the frustration of dealing with the medical system and attitudes than by the condition.

Could anyone imagine a well person being expected to recover from the effects of accidents or acute illnesses without necessary physiotherapy, treatments, or further follow up appointments? Yet it is expected of people who have a chronic condition, despite the knowledge that such incidents can exacerbate conditions. Is it because doctors are psychologically compartmentalising events into allowable chunks? Condition management is also pointless if patients cannot access the medical services at times when they need them most.

Patients also need to see the same doctor whenever possible, even if it means changing other …