Management of chronic disease by practitioners and patients: are we teaching the wrong things?BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7234.572 (Published 26 February 2000) Cite this as: BMJ 2000;320:572
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EDITOR: Clark (1), and Holman (2) in their articles consider that
practitioners who are trying to manage chronic disease are teaching the
wrong things to patients, and they suggest that an approach that enhances
the ability of patients with chronic disease is self management education,
a "new" form of empowering practice in health care based on empowering
patients to enhance their individual and community capacity (3). But, if
professionals have to understand and work with an empowerment approach,
they need opportunities to explore this process in their own professional
development and training (4).
Maybe, Spain is different from other countries, because there is a big
gap between real primary health care and university, where students are
taught yet within a biomedical model.
In this context, we have had some experience about training courses in
health education and clinical skills to primary health care professionals
(general practitioners, nurses, social workers, pharmacists,
veterinarians, psychologists) during the last ten years in the Health
Public School of Castilla-La Mancha, a regional postgraduate school, which
has as a core value education for empowerment through participation,
open agenda, holistic learning, awareness about causes of disease,
learning from each other more than from a teacher to students, and within
strategic analysis of possibilities to perform empowerment patient
education in everyday practice.
Unfortunately, in our experience, doctors and nurses -the nearest
professionals to patients - have more difficulties in understanding
empowerment education, and they have more resistance in applying this
strategy to manage patients with chronic disease, compared with other primary
health care professionals.
Perhaps, in many places, as in Spain, there is a long way go before
teaching is understood as a communication process to lead to empowerment, and
it can be used as a method of education, in order to facilitate
practitioners teaching the right things to their patients.
1.-Clark NM, Gong M. Management of chronic disease by practitioners
and patients: are we teaching the wrong things? BMJ 2000;320:572-575.
2.-Holman H, Lorig K. Patients as partners in managing chronic
disease. BMJ 200;320:526-527.
3.-Turabián JL, Pérez-Franco B. Utilidad y límites de la educación
sanitaria. FMC-Formación Médica Continuada en Atención Primaria.
4.-Rivers K, Aggleton P, Whitty G. Professional preparation and
development for health promotion: a review of literature. Health Education
José Luis Turabián and Benjamín Pérez-Franco
tutors of family medicine and professors of health education
Mancha Health Public School, Regional Centre of Public Health. Talavera de
la Reina, Toledo, Spain.
Address for correspondence :José Luis Turabián Fernández
Calderón de la Barca, 24. 45313 Yepes (Toledo)
Competing interests: No competing interests