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Chronic Disease and Treating “The Whole Person”

June 25, 2010
10:39 am

There is an interview well worth reading on Kaiser Health News today.  Kate Lorig is the director of the Patient Education Research Center at Stanford University and is the creator of an initiative called the Chronic Disease Self-Management Program.

With eight out of every 10 over-65 adults having at least one chronic disease, and with chronic illnesses accounting for over 70 percent of our nation’s $2 trillion annual healthcare bill, Dr. Lorig’s program is a valuable one.  The workshops and classes she initiated help chronic disease sufferers better communicate about their conditions engage in healthier lifestyles and do a more effective job handling their medication regimens.

The Kaiser interview caught my attention because Dr. Lorig makes an important point about the flaws in our healthcare system when it comes to treating many patients with chronic diseases.  She said:

“Right now, it addresses diseases or even parts of diseases or small sub-parts of the body. It does not address the whole, complex person with multiple chronic diseases. So, right now, what happens, if you’re lucky, you go to a primary care doc who kind of does the day-to-day stuff and then you see four or five specialists each of which do their little specialty part — none of whom really talk to each other except maybe to look at your laboratory tests on an electronic medical record if you’re really lucky. It is totally uncoordinated. It’s chaotic. It serves pieces of people, not whole people.”

To be fair, there are a number of forward-thinking healthcare systems in the United States that have adopted coordinated care models and do an outstanding job bringing primary care physicians and specialists together to treat patients with a holistic approach.  But, I can also attest personally, from overseeing my own father’s medical care, that there are too many cases where physicians aren’t communicating and don’t see the whole picture of a patient’s care when they recommend a new treatment or medication.

With over 50 percent of our senior population having multiple chronic diseases, it is clearly essential that coordinated care be the rule rather than the exception.  And, as we move forward with the implementation of health reform, this has to be one of the most important priorities.

2 Responses to “Chronic Disease and Treating “The Whole Person””

  1. pharmacy tech Says:

    Keep posting stuff like this i really like it

  2. heathero Says:

    I agree 100%!
    I am astounded by the lack of transfer of information, much less the lack of collaboration among physicians. Each one has such a narrow focus on the “symptom du jour”.
    In fact, recently my MIL was in the hospital and the hospitalist ordered loads of labs, cultures, etc. The nurse pointed out however that he ‘ordered everything he could, but those related to the GI tract he couldn’t. The surgeon had to order those when he came out of surgery’. As she put it ‘as a professional courtesy to the surgeon because she had had bowel surgery. So she had to wait 8hrs for those tests to be ordered so as not to ‘step on his toes’. Crazy! You would think that you could at least expect Docs who are on staff at the same hospital to work together as a team.

    It is truly scary. My grandmother has been in 3 hospitals over the past 3 mos. The one that she is in now has only 2 doctors. One is very conservative (no need for antibiotics, xrays, etc) then the next one comes on duty for 7 days and runs every test under the sun, and discovers 4 separate infections! She gets treatment for 7 days, but who knows what she will get when they ‘shift-change’.

    Great post, keep it up! ;)

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