The Acute Care/Chronic Care Difference; Why It Matters With Chronic Pain
by Shelley R. Smith, M.D.
It has been estimated that between 95 to 99% of chronic illness care is given by the patient who has the illness. On a day-to-day basis, the patient is in charge of his or her own health, and the daily decisions people make have a huge impact on patient outcomes and quality of life.
-Martha M. Funnell, M.S. R.N., Certified Diabetes Education, University of Michigan Health System, excerpt from article for the American Academy of Family Physicians
Acute injuries or illnesses differ from chronic illnesses or medical conditions. This is significant. Yet our current medical system often does not make this distinction obvious to patients.
Acute injuries or illness are defined as, “disease with a short course.” In contrast, a Chronic Illness or Condition is defined as a condition that lasts three months or more, that can often be controlled, but not cured. Examples of an acute condition include a strep throat, a fractured bone; a cut or laceration requiring a few sutures. Examples of Chronic Medical Conditions include Diabetes, Cardiovascular Disease, Rheumatoid Arthritis, Asthma and Chronic Pain.
When a patient has an acute condition, such as strep throat, or a minor laceration, they are frequently given a specific treatment or procedure, and told by their physician what they need to do to get better. This occurs because acute conditions are generally less complex, often having one main pathway of treatment. In contrast, with chronic conditions, there is not one cure; not one easy pathway to improving a patient’s life. It is here that the patient themselves makes the difference.
As it turns out, a patient’s day-to-day decisions can have a tremendous impact on their health. Lifestyle changes also can significantly impact medical conditions. Motivation, to make healthy decisions, however, is internal, and lies within the realm of the patient.
So what can a patient do to improve their chances of a better outcome?
Recognize that key elements of their care will be self-managed. Every decision a patient makes through the day, from whether they choose to take their medication, to whether they choose to take it as directed, to what they eat, to whether they exercise, has an influence on their health. Recognizing that they are the most important individuals managing their illness can go a long way.
Recognize they have options. Recent research has revealed many ways in which patients with Persistent Pain can turn down the volume on pain. Columbia Pain Management has one-on-one Pain Education classes that help patients understand the mechanisms behind their pain, and the many ways they can improve pain on their own.