During my student days in the late 1940s the idea of educating patients about their illnesses was never discussed. From memory I am not aware that this omission was even noticed, although it may have been by those students who were wiser and more broadly educated than myself. When later I began medical practice as a solo general practitioner, I remember being surprised by the number of patients who had had major surgical procedures (as judged by their obvious scars) and who were quite ignorant of these procedures or what organs they no longer possessed. I found this lack of available information often interfered with the process of diagnosis due to incomplete, and often highly relevant, past medical history.
Another memory of my early years in practice was the number of times I was called out of bed because a child had a fever, only to be met on arrival at the home by a mildly ill child playing with a box of toys. This provided sufficient motivation to start teaching the family about the relative unimportance of a single sign in assessing illness severity, and the need to look at the whole child and not just the thermometer reading. Within two years, despite an increasing population of children in a new suburb, there were two observable results. First, the number of such requests for night and weekend calls had markedly reduced and, second, there was positive feedback from patients, such as ‘Thank you for giving your time to explain things to me’. At the time many general practitioners were learning that this educational role was a legitimate and important part of being a competent general practitioner, which is not surprising since the word ‘doctor’ originally meant ‘teacher’.
When I moved to academia, I then had a chance, together with my colleagues, to develop these ideas further and to formalise patient education as an essential part of patient management in the context of today's society. Patient education now forms a major part of a formal undergraduate teaching program embracing a number of consulting skills. In addition to the verbal communication skills of this program, we have developed a matching series of take-home pamphlets to reinforce these educational messages.
John Murtagh has taken up the concept of extending the consultation by writing patient hand-outs focusing on illnesses and their management. These have been published over many years in Australian Family Physician, and adopted for use by many general practitioners during the consultation. They have been gathered together and rewritten in this format for use by doctors and other health professionals as an aid to improving quality of care, reducing its costs and encouraging a greater input by patients in the management of their own illnesses. The unique objective of this publication is the author's wish to encourage doctors to use the material and to photocopy or even modify those hand-outs considered most useful. A logical extension of this information is to use it in an electronic format; Patient Education is also available on computer software.
Many doctors, especially younger doctors and medical students, have claimed that Patient Education has been a helpful form of doctor education and very useful in preparation for examinations, both undergraduate and for the fellowship of the Royal Australian College of General Practitioners.
In a society where informed consent is increasingly expected by the public, and the legal profession in particular, it is important for doctors to be aware of the need to provide patients and families with much more information than in the past. Professor Murtagh is to be congratulated for producing the important messages in non-technical language within the confines of a single page. This no doubt is a result of many years of experience in general practice, where he has learned the skills of effective communication.
EMERITUS PROFESSOR NEIL CARSON, MD, AO,
Department of Community Medicine and General Practice,
Monash University, Melbourne