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December 22/29, 2004

Medical Education and Chronic Disease

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(24):2974-2976. doi:10.1001/jama.292.24.2974-b

To the Editor: I agree with the recommendation in the Commentary by Dr Holman1 for stronger emphasis on chronic disease in medical education and training. He rightly notes the expertise of patients, the relationship between patient knowledge and better outcomes, the importance of patient-physician partnership, the need for physicians “to understand what it is like to experience a chronic disease,” and the fact that patients have not been adequately acknowledged as members of the health care team for their own care. However, he does not specifically recommend that patients function as educators for both students and residents. Until patients are fully involved in providing education and training for physicians, the changes that are needed will not occur. A natural base for such patient involvement is existing community-based advocacy organizations for chronic conditions, such as those for breast cancer and for human immunodeficiency virus and AIDS. While providing valuable support for patients, such organizations are not yet significantly involved in how physicians learn. What is needed now is the development of collaborative patient-educator organizations (across conditions and advocacy groups) that can work with existing medical organizations to ensure that medical education and training fully incorporate the important knowledge patients have about chronic disease and how physicians can help meet their needs.

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