{"id":44581,"date":"2019-05-10T11:49:39","date_gmt":"2019-05-10T10:49:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44581"},"modified":"2019-05-21T15:13:29","modified_gmt":"2019-05-21T14:13:29","slug":"emma-cartwright-and-helen-macdonald-what-patients-think-and-how-they-have-changed-our-practice","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/05\/10\/emma-cartwright-and-helen-macdonald-what-patients-think-and-how-they-have-changed-our-practice\/","title":{"rendered":"Emma Cartwright and Helen Macdonald:\u00a0What patients think and how they have changed our practice"},"content":{"rendered":"<p><b>&#8220;What your patient is thinking&#8221;<\/b><\/p>\n<p><span style=\"font-weight: 400\">In 2015, <\/span><i><span style=\"font-weight: 400\">The BMJ <\/span><\/i><span style=\"font-weight: 400\">kicked off a new series called<\/span><span style=\"font-weight: 400\"> &#8220;<a href=\"https:\/\/www.bmj.com\/specialties\/what-your-patient-thinking\">What your patient is thinking<\/a>&#8221; (WYPIT) with a much discussed article on the language used around <\/span><a href=\"https:\/\/www.bmj.com\/content\/350\/bmj.g6845\"><span style=\"font-weight: 400\">weight loss<\/span><\/a><span style=\"font-weight: 400\">. Since then, the series has brought the patient&#8217;s voice and views to healthcare professionals, shedding light not only on what it is like to experience illness, but how healthcare providers can do better to support people to cope with and manage their health. \u00a0<\/span><\/p>\n<p><b>The series so far<\/b><\/p>\n<p><span style=\"font-weight: 400\">The series was created by the late Rosamund Snow, who also wrote a WYPIT about her experience of being diagnosed with type 1 diabetes &#8220;<\/span><a href=\"https:\/\/www.bmj.com\/content\/357\/bmj.j2012\"><span style=\"font-weight: 400\">Bereavement without a death&#8221;<\/span><\/a><span style=\"font-weight: 400\">. We have now published more than 40 articles; mostly written by patients, but more recently by carers too. These have covered many different aspects of care, but common themes include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/www.bmj.com\/content\/363\/bmj.k3119\"><span style=\"font-weight: 400\">Insensitive language and poor communication<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The \u00a0failure to see <\/span><a href=\"https:\/\/www.bmj.com\/content\/360\/bmj.j5920\"><span style=\"font-weight: 400\">patients as a whole person<\/span><\/a><span style=\"font-weight: 400\"> not just a health condition<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The positive impact of <\/span><a href=\"https:\/\/www.bmj.com\/content\/360\/bmj.k813\"><span style=\"font-weight: 400\">peer support<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/www.bmj.com\/content\/362\/bmj.k2784\"><span style=\"font-weight: 400\">Patient\/carer involvement<\/span><\/a><span style=\"font-weight: 400\"> in decision making<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">The range of health conditions and experiences covered have been equally broad from self-harm, anorexia, and diabetes to cancer and dementia. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Some of the most read articles in the series focus on <\/span><i><span style=\"font-weight: 400\">what it is actually like to be a patient or carer <\/span><\/i><span style=\"font-weight: 400\">including &#8220;<\/span><a href=\"https:\/\/www.bmj.com\/content\/360\/bmj.k1299\"><span style=\"font-weight: 400\">Be Brave<\/span><\/a>&#8220;<span style=\"font-weight: 400\">, &#8220;<\/span><a href=\"https:\/\/www.bmj.com\/content\/360\/bmj.k430\"><span style=\"font-weight: 400\">Appointment day\u2014the tip of the iceberg&#8221;<\/span><\/a><span style=\"font-weight: 400\"> and &#8220;<\/span><a href=\"https:\/\/www.bmj.com\/content\/360\/bmj.j5771\"><span style=\"font-weight: 400\">Letting my daughter go<\/span><\/a>&#8220;<span style=\"font-weight: 400\">.<\/span><\/p>\n<p><b>Learning for health professionals<\/b><\/p>\n<p><span style=\"font-weight: 400\">The vision for the series is to give patients a platform from which to suggest how care might be improved and how to make it more patient centred. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Many of the WYPITs have highlighted the importance of language. We have learned how even mainstream phrases and concepts such as \u201cdisease control\u201d or \u201cbeing brave\u201d can have an impact on self esteem, self management, and coping with difficult experiences. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Some articles have highlighted that some patients, or the public, have an assumption that clinicians have substantial power over the construction and processes of the healthcare system<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">though many clinicians may not share this feeling. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Patients have written about powerful examples of the deep and valuable expertise they have to share as partners in shaping their health and healthcare choices, as well as the system. Sometimes in the day to day rush of a doctor\u2019s working day you can lose sight of the need to hear about the burden of treatment, and other important factors in people\u2019s lives which are helping or hindering them in attending to their condition. You can end up treating the condition rather than talking about how to better support the individual who is self-managing it.<\/span><\/p>\n<p><b>Learning for editors <\/b><\/p>\n<p><span style=\"font-weight: 400\">The series has challenged us as editors in several ways. Particularly in finding the balance between sharing an authentic patient voice and in some cases avoiding defamation of health professionals. Another challenge has been how to present calls for change from patients which may be difficult for clinicians to implement. We have tried to ensure that our authors suggest clear learning points on something a healthcare professional could change tomorrow. We have also added reflective questions for clinicians to ensure that these articles are used in creating change.<\/span><\/p>\n<p><b>What next<\/b><\/p>\n<p><span style=\"font-weight: 400\">In the fifth year of the WYPITs series we plan to widen the spectrum of patient perspectives by interviewing patients or carers who may find it hard to write their story or simply prefer to talk rather than write. We are always interested in hearing from patients, or carers, who want to share their story on what it is actually like to live with or experience their health condition, diagnosis, or procedure. Finally, we would also like to hear your views on the series. If you use the WYPITs for learning or teaching, if there are any groups or perspectives you would like to hear about, or whether reading these articles has changed your practice, please do let us know.<\/span><\/p>\n<p><span style=\"font-weight: 400\">If you have a story or experience as a patient or carer that you would like to share, or would like to provide any feedback on the series then please contact the series patient editor Emma Cartwright at <\/span><a href=\"mailto:ecartwright@bmj.com\"><span style=\"font-weight: 400\">ecartwright@bmj.com<\/span><\/a><span style=\"font-weight: 400\">. <\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;What your patient is thinking&#8221; In 2015, The BMJ kicked off a new series called &#8220;What your patient is thinking&#8221; (WYPIT) with a much discussed article on the language used [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/05\/10\/emma-cartwright-and-helen-macdonald-what-patients-think-and-how-they-have-changed-our-practice\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":44586,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116,5749],"tags":[],"class_list":["post-44581","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-editors-at-large","category-patient-perspectives"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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