How to Manage a Chronic Condition

How to make the most of your next doctor’s appointment


How to make the most of your next doctor’s appointment

Being diagnosed with a chronic medical problem can be overwhelming. Management often requires routine monitoring, medication and lifestyle changes. While responding to symptoms and complications can seem isolating and confusing — those who suffer certainly aren’t alone. In fact, approximately 133 million people in the U.S. are dealing with one or more chronic medical conditions.

Chronic conditions not only take a heavy burden on those who suffer, they also drain the nation’s wallet. A recent report from the Institute of Medicine (IOM) identified the “big nine” diseases or conditions that cost the U.S. health care system billions.

Here’s the list:

  • Arthritis
  • Cancer in remission
  • Chronic pain
  • Dementia
  • Depression
  • Type 2 diabetes
  • Post-traumatic disability
  • Schizophrenia
  • Hearing and vision loss

For patients with these conditions — and patients with other chronic ailments such as hypertension and heart disease — finding the right physician can be key to keeping chronic disease in check and preventing further complications.

The continuum of care: from primary care to specialist

Without regular care, conditions such as diabetes, hypertension and heart disease can get worse, create other health problems and even be life-threatening. In fact, chronic medical conditions account for about 70 percent of all deaths, according to the IOM.

Many chronic diseases and conditions require the care of a specialist, but having a primary care provider is important too.

“Establishing a long-term relationship with your primary physician is essential to managing a chronic condition because they can recognize subtle changes in symptoms and treat the whole person,” says Dan Dworsky, MD, an internist at Scripps Health in San Diego.

“Specialists may see patients for one facet of their care. Without that longitudinal care, the medical management of a chronic condition can fracture, with no one having an overall view of the patient.”

Dr. Dworsky also notes that this long-term relationship allows the physician to better understand how patients’ illnesses are affecting them emotionally, physically, socially and financially.

Primary care — which can include internal medicine, family medicine and pediatrics — also offers a focus on wellness and prevention. These physicians provide regular health screenings for other conditions and can educate their patients about lifestyle decisions that improve health and prevent the development of additional problems.

Setting goals for better primary care

For each visit with a primary care physician, it’s important to set a specific goal to accomplish during that visit, whether it’s discussing medication, tracking progress, getting information or working through a specific health challenge.

“Patients often come in with a list of problems and concerns,” says Dr. Dworsky. “As physicians, we want to know about all their health concerns, but a list can sometimes distract us from understanding the main purpose of the visit, which means we may not have sufficient time to discuss their chronic disease management.”

Dr. Dworsky suggests people establish their goals with their physician within the first few minutes. If the appointment was intended to discuss diabetes, bring a list of questions and concerns that are directly related to that visit. This can keep the visit focused so both the patient and doctor can have enough time to discuss the problem.

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