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They may know best
There are two contrasting perspectives on the way patients and their parents use health services. When searching the literature on out of hours and emergency treatment, helpful keywords are "inappropriate" and "misuse." 1 Meanwhile, there is evidence that parents are more effective than professionals in the early diagnosis of a wide range of child health problems. 2 3
Three qualitative studies reported in this week's BMJ 4 5 6 address these contrasting views, which are at the heart of general practice. Children with trivial complaints, parental anxiety, and out of hours calls make major demands on general practitioners' time. But the antecedents of these calls make demands on the wellbeing of parents, usually mothers, whose hours of work and on call duties can make the commitment of even the most overworked general practitioner seem modest.
The two papers by Kai (pp 987, 983) explore parental concerns about childhood illness and communication difficulties between professionals and parents. 4 5 Based on group discussions and one-to-one interviews with parents in a disadvantaged inner city area, his work indicates parents' anxiety, sense of lack of control, and bewilderment at what they see as inconsistent prescribing patterns, unhelpful explanations, and opaque decision making. Kai advocates more information and education for parents. His title, "parents' difficulties," suggests where the problem might lie. But it takes two to tango, and "empowering" patients means recognising their...