Intended for healthcare professionals

Rapid response to:

Comment

Expert patients usher in a new era of opportunity for the NHS

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7402.1279 (Published 12 June 2003) Cite this as: BMJ 2003;326:1279

Rapid Response:

Research on the Expert Patient concept

The concept of the Expert Patient does indeed usher in a new era of
opportunity for us as health care professionals. I have just spent the
past year doing research on this concept, inspired by the document: "The
Expert Patient: A new approach to chronic disease self-manaegment for the
21st Century." I wanted to explore what it takes to become an Expert
Patient, and what we can learn from patients who would be considered ones.

My study was based in phenomenology. In the absence of an NHS
definition of an Expert Patient, I developed the following: An Expert
Patient is a person who has been empowered with the skills, confidence and
knowledge needed to play an active role in making informed decisions about
their own health care and management of their chronic condition. My
participants were individuals in my practice that I considered to be
exemplars of this definition. They told me that the wanted to be
considered capable and responsible decision-makers regarding their
condition. They developed an expertise on their own chronic condition by
living with it, obtaining knowledge from a wide variety of sources, and
from the support they received and got from significant others in their
lives. They recognized that they didn't always have expertise in the
clinical aspect of their condition, but they did have expertise in their
own condition. This is a rich resource for us to use.

I determined that the essence of the phenomenon of patient expertise
was trust. We need to trust that some of our patients will want to become
Expert Patients, and trust and respect their experiences of living with
it. They need to trust their knowledge and skills, us, and yet also earn
our trust in demonstrating their abilities to be capable and responsible
decision-makers.

The era of opportunity described in Donaldson's article is the
opportunity patients have to obtain what they need to develop expertise in
their own condition, and the opportunity we have, as health care
professionals, to practice in such a way that we work as co-experts with
our patients.

Competing interests:  
None declared

Competing interests: No competing interests

30 June 2003
Claire S Lightfoot
Registered Dietitian, Diabetes Educator
Campbell River Hospital, V9W 3V1