For 15 minutes I am supposed to chat about control of a disease, and blood tests and medications. The door is closed, and we can talk about tablets and blood tests, keeping the outside world at bay. Eventually, though, whatever happened in our consultation, we send the patient back to the environment they came from. For quite a few of our patients these environments contain the circumstances in which chronic diseases thrive.
We send them back to stressful jobs, or, even more stressful, lack of jobs. There may be no let-up at home, with the effects of long hours, low income, or poor housing all causing stress for families. The …