Consultant physicians working with patients - Royal College of ...

2 Specialties Respiratory medicineRespiratory medicineDr Lisa Davies BMBCh FRCP Consultant respiratory physician1 Description of the specialtyWho are the patients?Respiratory medicine is a varied, exciting andchallenging specialty. It is concerned with the diagnosis,treatment and continuing care of children and adults ofallageswithawiderangeofmorethan30respiratoryand related conditions.Main disease patternsThe second edition of Burden of lung disease 1emphasised the immense and growing health andeconomic burden of respiratory illness in the UK. ADepartment of Health (DH) review showed that thetotal spend on respiratory care in 2008–9 was£4,247,325,000. 2 Respiratory diseases kill one in fivepeople – more than ischaemic heart disease. Nearly30,000 people die of chronic obstructive pulmonarydisease (COPD) every year, and lung cancer kills morewomen than breast cancer. Respiratory conditions arethe most commonly reported long-term illness in babiesand children, up to one in five adults consult a GP for arespiratory complaint annually, and respiratory diseaseis the second most common illness responsible foremergency hospital admission, with cases of COPDtaking up more than one million bed days in Englandalone.Disease areas include: airway diseases:– nasal, upper and middle airway problems– asthma and other small airway conditions– COPD sleep-disordered breathing diffuse parenchymal lung disease (DPLD) andsystemic diseases that affect the lung:– inflammatory and scarring lung conditions– sarcoidosis– pulmonary manifestations of systemic diseasesand drugs pleural conditions:– malignancy– pleural effusion– pneumothorax– conditions of the chest wall, thoracic spine anddiaphragm occupational lung disease allergic lung and bronchial disorders infection:– cystic fibrosis– bronchiectasis– tuberculosis (TB)– pneumonia and empyema– infective and non-infective pulmonary disordersin immunocompromised hosts critical care and lung failure (acute and chronic) pulmonary vascular diseases:– pulmonary hypertension– pulmonary haemorrhage– pulmonary embolism lung cancer and mesothelioma genetic and developmental lung disorders paediatric lung diseases end-of-life care for malignant and non-malignantlung conditions public health:– smoking cessation and tobacco and nicotineaddiction policy– epidemiology and prevention.2 Organisation of the service and patternsof referralA typical serviceThe typical service provides many components thatcontribute to respiratory care delivered over whole-carepathways, including care at home, in the communityandinhospital.C○ Royal College of Physicians 2013 225