Diagnosis to chronic disease management

This rural physician feels that today’s generalists spend most of their time managing chronic disease, like hypertension, diabetes and heart disease, rather than diagnosing new disease. Which isn’t necessarily a bad thing, but not what it used to be:

Managing chronic illnesses can be very meaningful and satisfying, but it isn’t quite what I imagined I would be doing to this extent. But it is one of the reasons we need to hone our skills as physicians; it is no longer enough to be a good diagnostician when almost every patient we see in a given day already has a diagnosis established. Our challenge is to help them manage that diagnosis. That means we need to practice motivational interviewing for our patients with lifestyle-inflicted diseases, serve as our patients’ medical home in a fragmented health care system and be a voice of reason in an era of information overload.

Not sure that’s true, since I certainly find my share of new diagnoses over the course of a day. A lot can be uncovered by ordering the recommended USPSTF screening tests.

It’s true however that if you really want to see new, untreated diseases in a patient, you’d have to practice in a more remote area.

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