Talking cure - The Learning Exchange

paternalism – 'Dr Finlay is dead', they cry – to a model of partner- ship.9 But patient .... Real democracy within healthcare is still hard to come by.30. Emerging ... asked to choose services, the idea being that this drives efficiency through ...... prefer treatment that recognises recovery, in the broadest sense of recovering one's ...
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the talking cure why conversation is the future of healthcare Jack Stilgoe Faizal Farook

First published in 2008 © Demos. Some rights reserved Magdalen House, 136 Tooley Street, London, SE1 2TU, UK ISBN 978-1-84180-197-1 Copy edited by Julie Pickard, London Series design by modernactivity Typeset by Chat Noir Design, Charente Printed by Lecturis, Eindhoven Set in Gotham Rounded and Baskerville 10 Cover paper: Arctic Volume Text paper: Munken Premium White

the talking cure Jack Stilgoe Faizal Farook

Open access. Some rights reserved. As the publisher of this work, Demos wants to encourage the circulation of our work as widely as possible while retaining the copyright. We therefore have an open access policy which enables anyone to access our content online without charge. Anyone can download, save, perform or distribute this work in any format, including translation, without written permission. This is subject to the terms of the Demos licence found at the back of this publication. Its main conditions are: · Demos and the author(s) are credited · This summary and the address www.demos.co.uk are displayed · The text is not altered and is used in full · The work is not resold · A copy of the work or link to its use online is sent to Demos You are welcome to ask for permission to use this work for purposes other than those covered by the licence. Demos gratefully acknowledges the work of Creative Commons in inspiring our approach to copyright. To find out more go to www.creativecommons.org

Contents

Acknowledgements

6

1

Dr Finlay’s Facebook

7

2

The drugs don’t work (on their own)

19

3

More than words

31

4

The professionals

41

5

From the personal to the political

55

Appendix: Rich pictures from primary care

63

Notes

69

References

79

The Talking Cure

Acknowledgements Our pamphlet is built on the countless conversations that have made up the Healthy Conversations project. We owe a huge amount to the project partners: Diabetes UK, Pfizer and Rethink. Toni Borneo, Judith Luker, Saranjit Sihota and Steven Skyrme have given us insights and support throughout. We have also had invaluable contributions from the following members of the Demos team: Prachi Bhatnagar, Alessandra Buonfino, Peter Harrington, William Higham, Simon Parker and Waseem Yaqoob. Our project has drawn on the wisdom and expertise of a number of participants – the people we spoke to (Janey Antoniou, Sophia Bhatti, John Cain, Harry Cayton, Karishma Chandaria, Angela Coulter, Mark Duman, Mikis Euripides, Louise Fish, Brian Fisher, Martin Lodemore, Alexander McWhinnie, Annemarie Mol, Mary Teasdale and the Rethink National Advice Team), the attendees at our workshop (some of the above plus Rosemary Barber, Neil Churchill, Marce Colucci, Merav Dover, Simon Edwards, Louise Gilbert, Ivo Gormley, Trisha Greenhalgh, Tom Mann, Anne Matson, Mark Platt, Graham Reid, Richard Vautrey, Lauren White and Marlene Winfield) – and all the doctors and pharmacists who made up our focus groups. Thanks are due to all of them. Mistakes and shortcomings are of course entirely ours. Jack Stilgoe Faizal Farook May 2008

7

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Dr Finlay’s Facebook

A doctor is no longer at his intellectual peak just because he knows the best new methods… he must also have a talent for conversation that must adapt to every individual. Friedrich Nietzsche, 18781 A trip to the doctor is the start of a conversation that provides the link between our everyday lives and the medical profession. Each day in the UK more than a million conversations take place between doctors and patients.2 When governments, policy makers and others talk about healthcare, these conversations often fade into the backgroun