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The onset of a chronic illness such as Parkinson's Disease (PD) demands an urgent response to life's fundamental questions. General practitioners (GPs) who care for people with PD may also face anxieties, but these affect their professional rather than their personal lives. However, uncertainty at whatever level requires managing. Both patients and GPs adopt various strategies to resolve their difficulties. One aspect of this process concerns coming to understand, and explaining what to expect of the disease. Using data from in-depth interviews with people with PD and a separate group of GPs, this paper explores how the differing experience and management of uncertainty by both parties may, if unappreciated by doctors, hinder effective communication between them. Conversely, an imaginative understanding of what PD means may help transform people's experience of the illness. Training GPs to develop skills in understanding the special uncertainties of PD is considered. [ABSTRACT FROM AUTHOR]

This paper describes part of a qualitative project on patient doctor communication in the management of Parkinson's Disease. It explores how a group of general practitioners conceptualised the task of diagnosing patients with PD and the impact of diagnosis on a separate group of patients in terms of coherence and incoherence. My argument is that for GPs diagnosis represented a point of maximum theoretical coherence, whereas for patients it was a time of maximum experiential incoherence - a tension sharpened by reference to an analagous distinction: that between knowledge by description and knowledge by acquaintance. The paper further examines how GPs considered their own experiential knowledge helped patients by way of three key assumptions they held about PD and PD patients: namely, age, the comparatively protracted nature of the disease course and the availability of treatment. It asks how far patients found such notions helpful in their initial efforts to accept the diagnosis. I see this meeting point between two worlds simultaneously as tragic and potentially creative, with implications for more sensitive and effective interaction between patient and GP in this and other chronic illnesses. [ABSTRACT FROM AUTHOR]