It is important that the physician understands that the typical primary care consultation, which is often limited by the high volume of patients that need to be seen, is not the best forum for the delivery of asthma education. In this setting, the physician will often talk in a hurried fashion using technical language that the patient is unlikely to understand. The patient may fail to ask specific questions that will address his or her concerns. This interaction may also be hampered by physician ignorance of optimal asthma management techniques or the benefits of patient education. ventolin inhaler
In recent years, a number of consensus statements and guidelines for asthma education have been developed. The poor methods used in their development and the limited involvement of primary care physicians in their creation has been highlighted. In general, these guidelines have been developed by university-based specialists who see a skewed population of patients. The use of guidelines as a basis for changing patterns of practice raises concerns about physician acceptance, the medico-legal misuse of such guidelines and the abandonment of the art of medicine and accumulated clinical experience in favor of cookbook algorithms.
An Australian study has highlighted some of these difficulties. Bauman and colleagues surveyed 193 family physicians to assess the level of acceptance of a proposed community-based asthma education program. The rationale for the study was an earlier report showing physician resistance to such an intervention. In the Australian study, the survey was carried out among a group of physicians who had attended asthma-related continuing medical education (CME) events compared with a control group.
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