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

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Abstract
“This patient knows more about her disease than I do.” This passing remark was made more than 30 years ago to a group of new medical students as we stood around the bedside of a woman with longstanding diabetes mellitus. It is a sentiment that has probably been expressed or felt by doctors many thousands of times since. Yet until recently the wisdom and experience of the patient has been only a tacit form of knowledge whose potential to improve the outcome of care and quality of life has been largely untapped. In England alone, there are now nearly 10 million people with a chronic disease. It has been estimated that non-communicable diseases account for almost 40% of deaths in developing countries and 75% in industrialised countries. Strong evidence that the expertise of patients could be harnessed to play a part in addressing the challenge of this shifting burden of disease came from Professor Kate Lorig and her colleagues at Stanford University, California. She started to develop and evaluate programmes for people with arthritis …