The Hidden Curriculum of Patient Education for Low Back Pain in General Practice

Abstract

In this article I explore the implicit learning that occurs in and through doctor-patient educational encounters in general practice. Drawing upon a recent study of low back pain, I argue that whilst general practitioners appear to dominate the process of patient education, this process cannot be viewed simply as a repressive social control mechanism. Rather patients voluntarily choose to exert bodily self-controls in the light of patient education, due to their wider association with freedom, health and personal choice. Patient education for low back pain also offers opportunities for people to liberate their subjectivities so that social controls become redeployed or reappropriated for idiosyncratic or counter-hegemonic purposes.

The Influence of Patients' and Primary Care Practitioners' Beliefs and Expectations About Chronic Musculoskeletal Pain on the Process of Care

“…The other study explored GPs' beliefs about education and found that GPs felt there was not enough time within the consultation to deliver it even though they felt it was important. 20 This study found that GPs viewed education as preventive, and that many implicitly blamed patients for their low back pain, if they did not adhere to the educational program offered.…”

“…For 2 studies, we included several articles from the same study, as they reported different aspects of the study that were all relevant to this review. [18][19][20][21] …”

“…30 In another study, GPs seemed to be using their perception of patients' social class to inform their approach to treatment, with working class patients being provided with less detailed explanations of their problem than middle-class patients. 20 Gaining Trust Through Diagnosis and Referral (Table 4) Trust was a key issue for both patients and GPs. Patient's wanted to be trusted and to be believed when they talked about their symptoms, as many had previously been dismissed as malingerers.…”

“…24 Patient Education (Table 5) Patient education was explored in 2 studies. 20,21 The first explored the role of education within the consultation and the communication processes during education. 21 GPs believed that patient education was important, but that patients were not motivated to act upon it.…”

Patient School as a Way of Creating Meaning in a Contested Illness: The Case of CFS

“…It is also partly due to 'concerns about the inexorable rise in medical care costs' (Bartlett, 1986: 141). The major part of patient education (compared to health education, which is concerned with the asymptomatic individual or population (Skelton, 1998)) seems to concern the practical management of chronic illnesses like diabetes, hypertension and rheumatoid arthritis (RA) and to help patients to help themselves (cf. Bartlett, 1986;Lorig, Konkol and Gonzales, 1987).…”