by Ellen Taliaferro, M.D.

The Old Timer sat in his doctor’s office and pondered his future. “Tell me, Doc, if I give up smoking, sex, alcohol, salt, sugar, fat foods, and caffeine, will I live to be 100?” “No,” the doctor told him. “But it will sure seem like it.”

This old medical joke underscores the reality that longevity and well-being do not automatically walk down the street of life together, hand in hand. In fact, the longer we live, the more likely we are to fall victim to a chronic disease of one form or another.

A recent Reuters article reports that in 2005, 44 percent of Americans were coping with at least one chronic disease, such as diabetes, hypertension, arthritis, cancer, or heart disease. These chronic diseases are the leading causes of disability and death in the United States. Many Americans now have three or more chronic diseases. According to 2004 study from the Centers for Disease Control and Prevention, one in 10 Americans has a chronic disease that causes major limitations in daily living.

Chronic diseases, as opposed to acute illnesses, tend to develop over a long period of time and linger longer than three months. Like acute illness, a chronic disease can have mild, moderate, severe and even fatal consequences. Most require the attention of a healthcare provider, and patients with chronic diseases are often prescribed multiple medications.

Unlike acute illnesses, which often resolve with or without medical intervention, chronic diseases are frequently here to stay. Many are, by definition, diseases without a cure. Chronic diseases demand a different form of healthcare delivery. The current healthcare system provides single-dimensional, segmented and episodic care that is institution-based and disease-oriented. Chronic illness tends to be multidimensional, ongoing, disabling and a very personal experience for each patient with the chronic disease.

What can be done to help those with chronic illnesses? If chronic disease sufferers cannot be cured, can they at least experience healing in one form or another? Indeed, they can.

Let’s start with definitions. The dictionary definition of a cure is an intervention that relieves the symptoms of a disease or condition by eliminating the disease or condition. Healing on the other hand restores and alleviates the  distress and anguish of a condition, even though the underlying condition persists.

In reality, curing and healing are further differentiated by the fact that curing tends to be a passive process for the sufferer of a condition. Disease strikes. Care is then sought from a healthcare provider who prescribes a pill or procedure. The symptoms of the disease then resolve. The patient is said to be “cured.” But did the symptoms resolve because of the treatment? Or did the “tincture of time” simply result in the disease disappearing? The latter possibility may account for more healing than we realize as reflected in Benjamin Franklin’s observation that “God heals, and the Doctor takes the Fees.”

Healing, on the other hand, is an active process in which the bearers of a disease take steps to enhance well-being and to alleviate their symptoms and distress.

The stage is now set for a new concept of care, that of engaging “patient power” to achieve healing for the current chronic-disease epidemic that accounts for 70-80 percent of all physician visits and consumes 90 percent of every healthcare dollar spent. Patient power calls for the bearers of the illness to become full partners in their own healthcare by developing patient expertise about their conditions and assuming responsibility for managing their care.

Healthcare experts are now recognizing that about 90 percent of the care needed to manage a chronic disease must come directly from the patient.

This realization provides the cornerstone for a new movement of “patient self-management.” Chronic disease self-management programs are now being instituted and studied at many academic institutions. In general, these programs call upon patients to:

• Learn as much as they can about their conditions.

• Commit to following a care plan once one is in place.

• Actively share in decision-making.

• Monitor and manage their signs and symptoms.

• Manage the impact of their conditions.

• Adopt lifestyles that promote health.

The mortality of every disease and condition varies. The mortality for life in general remains steady at 100 percent. Perhaps the Old Timer seeking to live to be 100 by stopping things would be better served by starting to do things that would promote his own “patient power.”

On the Net: Reuters article on chronic disease: http://tinyurl.com/bjapml.

Ellen Taliaferro is a local physician, speaker and author. You can learn more about her work at www.ellentaliaferro.com and www.healthaftertrauma.com. To contact her about speaking to your group, please e-mail her at DrTSpeaks@gmail.com or call 650-393-3660.