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Books, Journals, New Media
July 7, 2004

Mobility Dysfunction

JAMA. 2004;292(1):108-109. doi:10.1001/jama.292.1.108-b

Each patient is unique, mixing the varying effects of medical, psychological, social, cultural, religious, and other factors to give a picture unlikely to be exactly duplicated. This oft-cited but less often honored saw is even truer in patients with chronic functional impairments. With chronic impairment added, the patient's expectations become more important, and they may be very different from the physician's. Physicians, from their training and inclination, aim to cure—failing that, to manage (control)—and failing that, to palliate. Patients, on the other hand, tend to be concerned with the present and immediate future—specifically, their quality of life. Many, probably most, patients with chronic progressive disease already know or sense that they will not be "cured" but still want help in bettering their quality of life. Quality of life involves functions—mobility, seeing, hearing, eating, bathing, bladder and bowel control, sex, and more—that neither physician nor patient may adequately explore. Patients may feel these problems are not "medical" and, therefore, of no interest to the doctor, and doctors may feel they have little to offer. (Time restraints, of course, contribute to the evasion by both parties.) When Walking Fails examines in detail the attitudes and actions of all sides who deal with mobility dysfunction.