Patient Services in Chronic Diseases

Abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. Association of Schools of Public Health is collaborating with JSTOR to digitize, preserve and extend access to HE HEALTH and medical care resources and facilities generally available in our country were developed in response to the demands of acute illness. It is now inevitable and desirable that these same resources be directed toward the demands of chronic illness, which has become the main preoccupation of those in the public health and medical care fields. In determining the changes in philosophy and facilities which our medical resources must undergo to deal with this new problem, it may be worthwhile to contrast the characteristics of the acute illnesses which have occupied us in the past with those of the chronic illnesses which will occupy us in the future.The most obvious characteristic of acute illness is dramatic onset. The healthy individual develops signs and symptoms such as sharp pain, high temperature, or coughing of blood which make clear to the patient, to the family, and to the physician that serious illness is present. In acute disease the length of illness is usually brief, most often measured in days, and the illness is marked by a crisp, definitive end point. Most often the patient makes a complete recovery, returning to good health and the activities, pursuits, and responsibilities which characterized his life before the acute illness. The characteristics of most serious chronic diseases are so different as to be almost the obverse side of the coin.The onset of many of the chronic diseases is so insidious that often the individual will not clearly recognize that there is anything seriously wrong with him. There is no qualitative relationship between the presenting symptoms and the severity of the underlying disease.

Physicians' Attitudes Toward the Ill Aged and Nursing Homes*

“…Cherkasky (11) commented that the view of chronic disease held by the public and even by some physicians is colored by misconceptions, e.g., that chronic disease is indolent, not much can be done for the chronically ill, and not as much or as high-quality medical care is needed for the chronically ill as for the acutely ill.…”