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While broswing this evening I stumbled on this from Yahoo! Health: It reminded me of some of the very negative reactions I give students who call someone with diabetes, a "diabetic" ... when the accepted terminology is a "person with diabetes". In this more politically correct environment, to call someone a "diabetic" is considered labelling, in a similar way to calling a person with leprosy, a "lepor".... ie its frowned upon.

What say you?

CP

PS. During one class, a student did repsond by asking if I was really a "lecturer" or a "person who lectures"

I try to refer to people as " a person with X" as opposed to "an X". There is much more to a person than their disease.

I'm trying to drum this into my Mum's head at the moment. A friend of the family has just delivered a baby with Down Syndrome (not suspected despite all the testing done so quite a shock, but another story altogether). Mum keeps referring to their "Down Syndrome Baby" I'm trying to get her to realise he is their baby, who happens to have Down Syndrome or more correctly Trisomy 21!!

I find the important distinction lies in talking about a specific person with diabetes versus the more generic 'diabetic' when lecturing/giving examples etc. If I am refering to an individual, then I prefer to talk about 'Mrs Jones who has diabetes'. But if I am referring to the population of patients who have diabetes, then I will more lazily and conveniently refer to 'the diabetic patient'.

Here's a thing. I once worked for a well known community based organisation representing people with arthritis. Now, we would never refer to a person as 'an arthritic', as that would not be politically correct. It was always a 'person with arthritis'. Problem was that in meetings, memos, papers etc we took to abbreviating this to PWA. So we referred to people as a PWA which, if you think about it, is really as dodgy a shorthand as anything. I guess we tend towards to the lazy position.

However, I would certainly support OFITG in your push to have your Mum refer to (and most importantly conceptualise) the new wee babe as a 'person with Down's Syndrome' - I guess that comes from my position as a Mother!

cheers,

Felicity

I have an inbuilt reflex that the 3rd yrs are really good at triggering at the start of the year....by the end of the year its rarely happens, except sometimes in a clinical exam. Saying "Mrs X is a diabetic" usually elicits an automatic evil stare from me ... the really smart students usually realise immediately what they did wrong....by the end of the year is usually "Mrs X has diabetes"

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

just wondering if mrs x refers to herself as "a diabetic" does it illicit the same evil stare?

__________________
malpractice makes perfect

That usually elicits more of a "raised eyebrow" type of response then I stare at the student (not necessarily an evil one) to see if they noticed :) .... over the years my response has become very much like a reflex.

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Netizens

Interesting thread, Many clients of podiatry live with co-moribund pathology and it would be reductionist to consider diabetes as the only focus. Indeed something which has been cited in the literature as a barrier to achieve optimal health outcomes is the therapist's limitation in understanding living with disease. One potential disadvantage of published clinical pathways based on homogenous best practice is the limitation to deal with varience cause by modifying circumstance. Dwarfs may be dwarfs but understanding the biopsycho social aspect of being height challenges in a society which marginalises certainly makes people more aware of being height challenged.

Craig wrote
>PS. During one class, a student did repsond by asking if I was really a "lecturer" or a "person who lectures"

To continue this a little further are academics, podiatrists that teach and research; or professional educators who prepare graduates for vocational podiatry but not necessarily practice? I am always amused as a academic you need to have current registeration as a practitoner to teach. Do people who teach accountants, need to be practising accountants? The simple answer is no. Could this reflect we as a profession still prefer craft over thought? Heaven forbid!

Worth a thought

Cameron
Hey. what do I know?

__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

I'm more interested in the possibilities of moving Craig's face by remote control. So, with the correct sequence of words and phrases you can get a series of stares, frowns, eyebrow twitches and so on. Fabulous! Craig - be warned, from now on in staff meetings I will be endeavouring to find the perfect combination of words/phrases to make your face contort to my every wish.....heh,heh,heh. Am I a Podiatrist or a lecturer, nope, I'm a psychopath.

Felicity

"Are we there yet?"

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Sorry guys, I will have to be in opposition camp on this one. Labels, no matter how 'reductionist', are part of society. Just because its a health condition that's the label, shouldnt make it more or less acceptable in general conversation. Political correctness is a disease in itself me thinks...

I go to work to as a podiatrist (not a person who practices podiatry), and I am a part time lecturer (ie person who lectures) and a registrar in podiatric surgery (ie surgical trainee {ie person who trains}). At work, my "girls" ("shock-horror" - ie reception and admin team) keep my patients (ie clients {ie people that pay to see the person who practices podiatry} happy.

My mate is a quadraplegic (ie person who severs spinal cord at appropriate level to lose full use of arms and legs). He would think I would be taking the piss out of him if I introduced him as a "person who has quadraplegia". You *never* hear quad's and para's complain about this type of labelling.

I have worked for many years in a tertiary diabetic centre and the phrase "person with diabetes/PWD" only exists on rounds and in journals. Sitting around in the tea room, everyone discussed is still a diabetic. Who cares?

Joke:
An engineer, a physicist, a mathematician, and a psychologist are stuck in a burning building. Who gets out alive?

This message should not be sent because it encourgages classism, elitism, and implies that those who study different disciplines deserve to perish in a tragedy through no fault of their own. Tandem Values require respect for all individuals in all jobs they do.

LL

LL.

You make some valid points. But for me the change from a diabetic to someone with diabetes struck a chord.

As a private practitioner working in England, I am not exposed to those diabetics with complications of the disease.

When a new patient says to me 'I am a diabetic', my response is always to establish the duration of the diagnosis, method of control, success of control and any identified complications.

I see 'diabetes', ie a condition which describes 'an insufficiency of insulin for the bodies needs', as a disease of variable presentation, from the early onset non compliant insulin dependant, to the 85 year old obese recently diagnosed female with heart failure.

For that reason I like the move to a person with diabetes.

Bob

this is not a subject i have given much thought to as my terminology has never been questioned by patients, so I asked one of my diabetic patients how he would react if i called him "a diabetic" and interestingly he replied he would not be concerned, however he feels he needs to make people aware that he has type 1 diabetes as he feels the perception of this is that it is "genetic" as opposed to type 2 which is seen as "self inflicted"

my own feelings on the subject are that refering to someone as "a person with diabetes" is as much of a label as "a diabetic" just with a few more frills and bows on. When assessing a patient/ taking a history i generally use terminology along the lines of "so mr/mrs x i understand you are diabetic", more a statement of fact. if i used "so mr/mrs x i understand you are a person with diabetes" i get the feeling people would think i am extracting the michael and i fear death by blunt instrument. i have never had a reaction to calling anybody "a diabetic" and i am sure this has happened frequently in the course of practice.

in my experience people prefer to have a spade called a spade and i practice in a rural area so i feel they know what they are on about

__________________
malpractice makes perfect

Andy
The response of your type 1 diabetic is interesting, and I think is consistent with my views of the 'disease'.

What I do find interesting is your use of 'a diabetic' but when you describe your conversation you use 'you are diabetic'.

The definite article 'a' is IMO very significant in that it's use 'defines ' the subject, where it's absence is not labelling.

I am not a politically correct person, far from it, but I think describing people by their 'disease' is unproductive.

I discussed this with my wife, a social worker (label) and some one who suffers from Asthma, yes she is asthmatic, rides horses, picks up 'poo' from 2 acres of ground every day, so what is an Asthmatic, the lady I saw last week with classic clubbing of fingers and toes confined to a chair.

Just some thoughts

Bob

"are you a diabetic" = "are you a person with diabetes".............both labels........we're all labelled....."are you're a boy" = "are you a person with testicles"............haven't had a PATIENT yet who has complained / seemed upset...18 years.........in a past life have nursed "quadraplegics", they would have ribbed me badly if i wasn't straight with them .....

I agree, that "patients" do not care. I have had many discussions about this with patients.

However, as I explain to the students ... be careful with the terminology around diabetes nurses (educators and specialists) as they are more sensitive to the polictical correctness .... as for diabetes physicians .... they don't care either. :p

BTW: was a 'private' joke that only LTU staff will understand ...

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

surely then it would be better if we educated the educators as they appear to be the uneducated

__________________
malpractice makes perfect

I would disagree that the punters mind what they are called, surely it will depend if they see diabetes as an illness or disability or a nuisance - many do not so they have but do not suffer from diabetes. Words are very important as are labels - many of my patients prefer being called by their given name (ie not Christain note!) rather than family name and marital status - another can of worms.

As a diabetic, or a sufferer of diabetes, or a person with a chronic condition called diabetes, I guess I must therefore be a podiatry student or a student of podiatry or ..........??

I don't think I ever say ' I have diabetes' but that I am a diabetic. Maybe just let those with the condition decide what they want to call themselves rather than using so called PC speech which the entire world seems to be hell bent on using??

For me, the "person with diabetes / diabetic" issue is not about labelling, or what I refer to them as, as that in itself is largely irrelevant, and as a PP indicated,"political correctness" - using the quadriplegia as an example.

The important differentiation for me is to remember there is more to a person than their illness or disease. It's about the concept rather than the label....looking beyond the "label" and trying to see the whole person.

That's the reason I work in Community Health, not Private Practise.

I am interested with the patient you ask "Do you have diabetes?", and they respond, "No, but I ve been diagnosed with it". A little delving into that issue reveals as they are only told to take their BSL s first thing in the morning (before breakfast), and last thing at night (hours after dinner), their BSL s are around 4 or 5, hence they dont believe they have diabetes.

I have these people do their BSL s first thing in the morning and two hours after breakfast, and lo and behold their BSLs are around 10 on the second test. Then they believe they shouldnt have bacon and eggs for breakfast like they ve been told, and become much more "compliant" (I apologise for the use of that terminology Craig).

Why do GPs/Diabetes Educators persist in telling people to only test their BSLs first thing in the morning?

Interesting answer One Foot....are you saying that Private Practice offers less holistic care than Community ??? In my experience, both as a diabetic (prior to becoming a student) and as a student, community care within the NHS is nothing less than fire brigade podiatry...do the minimum or maximum that time allows and see you again whenever we can fit you in. At least when I see a private Pod who is v good and better qualified than a lot of NHS Pods...she has time to treat me properly and doesn't say anything about wearing Ecco shoes !

Hi Tully,
No idea re nurses advising re taking bloods...mine told me to take them as/when I liked. I am diet controlled and long may that last. So long as I stay under 7.0 most of the day and under 10, 2 hrs after eating its good for me and her and the quacks. I take readings more when I have a bug as I know my body and know that my levels rise. I also know v quickly when I am close to hypo and to hell with people who say that I cannot get hypo when I am not on drugs. They have no idea what it is like!

More worrying is that the government have yet again dropped the cholesterol levels down so that it is now 4.0 and how many people can get that low without statins?? Now THAT is when it starts to get dangerous !
When GP's start prescribing drugs because they get a rake off...................Mmmm???!!