Self-Management Support

Examples of gaps and weaknesses in our current acute care system

People with chronic illnesses have fragmented information and support systems in the communities where they live and make daily disease management decisions (what they eat, how they exercise, how they take their medications).

The physician-patient relationship is traditionally top-down and directive: physician is "the expert" and patient must "comply" with instructions.

Physicians have short time slots for visits and cannot afford to take the time to help patients understand their disease; diabetes educators, nutritionists, and counselors are rarely adequately compensated and are rarely co-located with physicians, requiring additional visits by patients to multiple locations.

Examples of implementations of the chronic care model
(these are illustrations and not necessarily prescriptions or endorsements)

Communities where people live and work have highly visible, integrated support systems in place to help people with chronic illnesses make informed choices about their lifestyle and disease management.

The physician-patient relationship is collaborative (could use "motivational interviewing" techniques, for example); the patient is a recognized expert in living with his/her chronic illness.

Physicians are part of a care team, co-located and adequately compensated to spend the time with patients for education, training in self-management tools, and routine assessment of problems and accomplishments.