THE DOCTOR-PATIENT-RELATIONSHIP AND THE MANAGEMENT OF ASTHMA

General practitioners (GP) differ in views on how to relate to their p atients, diagnose asthma and update their knowledge. By understanding the doctors' attitudes within these domains it is possible to design a better information strategy and improve disease management. In order to gel insight in the doctors' experiences and ways of thinking regard ing asthma, 20 GPs were interviewed. A phenomenographic analysis was a pplied in describing the doctors' opinions. The doctors' opinions abou t who was in charge of the asthma management defined four doctor-patie nt relationships: I will manage it, you will manage it, we will manage it and I do not know whether I will manage it. The GPs differed marke dly in how much they trusted the patients' descriptions and the physio logical measurements of the disease. Three opinions on how to acquire knowledge were described. Knowledge should be acquired either from exp erts or from peers. Another belief did not give weight to a defined so urce bur expressed the necessity of using all opportunities at hand. D octors holding this belief, ''the bricoleurs'', seemed to be more inte rested in a ''how to do it'' than a ''why to do it'' information. We c onclude that strategies for improving asthma management should conside r the importance of both patients' accounts and physiological measures , the degree of co-operation between doctors and their patients and ev entually the ways and styles of acquiring new knowledge about asthma. (C) 1998 Elsevier Science Ltd. All rights reserved.