The doctor-patient relationship and the management of asthma

General practitioners (GP) differ in views on how to relate to their patients, 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 regarding asthma, 20 GPs were interviewed. A phenomenographic analysis was applied in describing the doctors' opinions. The doctors' opinions about who was in charge of the asthma management defined four doctor-patient 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 markedly in how much they trusted the patients' descriptions and the physiological measurements of the disease. Three opinions on how to acquire knowledge were described. Knowledge should be acquired either from experts or from peers. Another belief did not give weight to a defined source bur expressed the necessity of using all opportunities at hand. Doctors holding this belief, "the bricoleurs", seemed to be more interested in a "how to do it" than a "why to do it" information. We conclude that strategies for improving asthma management should consider the importance of both patients' accounts and physiological measures, the degree of co-operation between doctors and their patients and eventually the ways and styles of acquiring new knowledge about asthma. (C) 1998 Elsevier Science Ltd. All rights reserved.