This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (27)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Medical Education  • Quality of Care, Other  • Alert me on articles by topic

Halsted Holman, MD

JAMA. 2004;292:1057-1059.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

It is axiomatic that medical education should prepare students well for the clinical problems they will face in their future practice. However, that is not happening for the most prevalent problem in health care today: chronic disease.

The inadequacy of clinical education is a consequence of the failure of health care and medical education to adapt to 2 related transformations in the past 50 years that are central to good health care today. In the first, chronic disease replaced acute disease as the dominant health problem. Chronic disease is now the principal cause of disability and use of health services and consumes 78% of health expenditures. In the second, chronic disease dramatically transformed the role of the patient.

The differences between acute and chronic disease are substantial. Acute disease is episodic. The patient is usually inexperienced and passive while the physician administers treatment. There is commonly a . . . [Full Text of this Article]

Author Affiliation: Stanford University, School of Medicine, Palo Alto, Calif.

RELATED LETTERS

Medical Education and Chronic Disease
Stuart Green
JAMA. 2004;292(24):2974.
EXTRACT | FULL TEXT  

Medical Education and Chronic Disease
Margaret Kirkegaard
JAMA. 2004;292(24):2974-2975.
EXTRACT | FULL TEXT  

Medical Education and Chronic Disease
John G. Brehm
JAMA. 2004;292(24):2975.
EXTRACT | FULL TEXT  

Medical Education and Chronic Disease
Nancy Morioka-Douglas
JAMA. 2004;292(24):2975.
EXTRACT | FULL TEXT  

Medical Education and Chronic Disease—Reply
Halsted R. Holman
JAMA. 2004;292(24):2975-2976.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Beyond Fighting Fires and Chasing Tails? Chronic Illness Care Plans in Ontario, Canada
Russell et al.
Ann Fam Med 2008;6:146-153.
ABSTRACT | FULL TEXT  

Patient Knowledge of Coronary Risk Profile Improves the Effectiveness of Dyslipidemia Therapy: The CHECK-UP Study: A Randomized Controlled Trial
Grover et al.
Arch Intern Med 2007;167:2296-2303.
ABSTRACT | FULL TEXT  

Self-management of chronic conditions: the legacy of Sir William Osler
Creer and Holroyd
Chronic Illness 2006;2:7-14.
 

Bridging the knowledge--action gap in diabetes: information technologies, physician incentives and consumer incentives converge
Nobel
Chronic Illness 2006;2:59-69.
ABSTRACT  

Medical education and chronic disease
Miller et al.
CMAJ 2005;172:858-858.
FULL TEXT  

What is chronic illness?
Dowrick et al.
Chronic Illness 2005;1:1-6.
 

Medical Education and Chronic Disease
Brehm
JAMA 2004;292:2975-2975.
FULL TEXT  

Medical Education and Chronic Disease
Green
JAMA 2004;292:2974-2974.
FULL TEXT  

Medical Education and Chronic Disease
Kirkegaard
JAMA 2004;292:2974-2975.
FULL TEXT  

Medical Education and Chronic Disease
Morioka-Douglas
JAMA 2004;292:2975-2975.
FULL TEXT