Chronic Illness

The family physician must also be committed to managing the common chronic illnesses that have no known cure, but for which continuing management by a personal physician is all the more necessary to maintain an optimal state of health for the patient. It is a difficult and often trying job to manage these unresolvable and progressively crippling problems, control of which requires a remodeling of the lifestyle of the entire family.

About 45% of Americans have a chronic condition. The costs to individuals and to the health care system are enormous. In 2000, care of chronic illness consumed 75 cents of every health care dollar spent in the United States (Robert Wood Johnson Foundation Annual Report, 2002).

Comorbidity, the coincident occurrence of coexisting and apparently unrelated disorders, is increasing as the population ages. Those age 60 years or older have an average of 2.2 chronic conditions, and physicians in primary care provide most of this care (Bayliss et al., 2003).

Diabetes is one of the most rapidly increasing chronic conditions (Figure 1-2). Quality of life is enhanced when care of diabetic patients is provided in a primary care setting without compromising quality of care (Collins et al., 2009).

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