RT Journal Article SR Electronic T1 The expert patient: a new approach to chronic disease management for the twenty-first century JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 227 OP 229 DO 10.7861/clinmedicine.2-3-227 VO 2 IS 3 A1 Robert Tattersall YR 2002 UL http://www.rcpjournals.org/content/2/3/227.abstract AB The expert patient: a new approach to chronic disease management for the twenty-first century, produced by the Department of Health, recommends the introduction of ‘user-led self management’ for chronic diseases to all areas of the NHS by 2007. The premise is that many patients are expert in managing their disease, and this could be used to encourage others to become ‘key decision makers in the treatment process’. Furthermore, these expert patients could ‘contribute their skills and insights for the further improvement of services’. It is hypothesised that self-management programmes could reduce the severity of symptoms and improve confidence, resourcefulness and self-efficacy. It is stressed that this is more than just patient education to improve compliance. Instead there should be ‘a cultural change … so that user-led self management can be fully valued and understood by healthcare professionals’. I point out that these ideas, while welcome, are not particularly new. Achieving the desired culture change will not be easy.