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Speech by Dr Lorraine Baker at Diabetes Australia's Language Position Statement Launch
21 September 2011
In speaking on behalf of AMA Victoria at the launch of Diabetes Australia’s new language position statement I would like to acknowledge that this statement highlights issues that can cause guilt and a sense of failure in individuals who suffer diabetes.
Doctors understand the impact that language can have when treating patients. The doctor-patient relationship is not an equal one and the words chosen by doctors have a powerful impact on the way that patients view their condition, their treatment and themselves. This statement offers an alternative vocabulary to assist in helping people with diabetes to achieve better health.
It is at a political level that AMA both in Victoria and federally has worked hard to overcome other issues around language and diabetes. When it was proposed by the Federal Government to implement a Medicare one-size-fits all item number for primary care management of diabetes, the AMA vigorously opposed the concept because the profession knows that patients with certain conditions including diabetes can become defined by that disease
We must avoid defining patients by a diagnosis. Very few patients with diabetes have that condition alone, and co-morbidities such as depression, osteoarthritis, hypercholesterolemia and hypertension may be of more significance in certain patients than a focus on diabetes control alone.
Diabetes Australia is to be congratulated for reminding us all that for different patients , certain words have different meanings- and in patients who are struggling with a diagnosis and the management of their diabetes - a change in language may assist -especially in the area of self-blame. This is particularly true in relation to Type 2 diabetes.
At a public health level our concern is that with the number of individuals suffering Type 2 diabetes increasing in prevalence in our society and the acknowledgement that this is due to a greater prevalence of lifestyles with a negative impact on health - the individuals with diabetes may feel blamed for their condition.
For the AMA this is a political issue - the increasing prevalence of Type 2 diabetes cannot be managed by one-on-one interventions alone. Broader policy failures and cultural shifts have not protected the population against lifestyle factors that contribute to this.
From traffic light labeling of food, to improved public transport, to public education campaigns for healthy eating and exercise, to an increasing emphasis on public open space - we will continue to lobby for population based interventions because, as this position statement acknowledges, the blame and solution cannot and should not be attached to individuals with diabetes, and the language in public discourse as well as in clinical settings needs to change.
Dr Lorraine Baker
AMA Victoria Board Member
Victorian Medical Directory
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