Medical expertise was questioned by Jim, and having another
chronic illness label meant that asthma did not receive
equivalent medical attention.
Medical management sometimes led to a narrow focus,
whereas effective management of asthma demanded that the
person’s life be viewed in context, and not only as a diseasespecific
response. Frasier made a claim for holistic management
of his asthma:
Well, this rather interests me because I have been asthmatic for years.
I have a good background of science. I think we need the set up of
special clinics that can give a holistic view of people and their
medications, dietary habits, dangers of things like preservatives…It
compounds the trouble. I attended a respiratory specialist and he was
not interested in anything outside the immediate present. I’m still
having problems. He said, ‘Carry on’, [but] it’s not really the answer.
Older people with asthma often found themselves in a
medical management model. However, this meant that the
doctor’s orders were followed and medications were taken as
prescribed; otherwise the patient might be labelled as noncompliant.
Doctors were likely to be trusted if they provided
evidence that they had specific disease knowledge and could
offer sound medical advice. For health care professionals,
self-management was viewed as the patient adopting appropriate
practices in relation to their disease. Medical management
took a narrow view whereas management of asthma,
because of the long-term nature of the illness, deserved to
placed in the context of the person’s life. In this model the
person was objectified as ‘the patient’.