A majority of physicians contacted in a national survey said their skill levels were too low to adequately care for chronically ill patients.
Specifically, nearly two-thirds of family physicians, pediatricians, internists and surgeons surveyed reported feeling poorly trained in skills related to the care of chronically ill patients.
The study was conducted by researchers from Johns Hopkins University, Baltimore, who found that family practitioners and younger physicians reported higher levels of satisfaction with their training, suggesting that medical schools are beginning to address the problem.
"Despite the prevalence and burden of chronic illness, healthcare delivery in the United States is largely organized and financed around acute illness," said Eric Bass, M.D., study co-author and associate professor of medicine at Johns Hopkins, in a news release. His work was published in the June issue of Academic Medicine.
Survey researchers interviewed a random national sample of 1,236 physicians about their attitudes toward caring for the chronically ill. Overall, upward of 60% percent of physicians reported they had not received adequate training in 10 chronic-care skills:
- approaches to educating the chronically ill
- end-of-life care
- coordination of in-home and community services
- management of geriatric syndromes
- management of psychological and social aspects of chronic illness
- assessment of caregiver and family needs for patients with chronic illness
- chronic pain management
- interdisciplinary teamwork with nonphysician providers for the chronically ill
- assessment of developmental milestones in chronically ill children
"This finding indicates that some change in the culture of medical education has taken place over the past decade, perhaps as new physicians have adjusted their practice expectations to changing patient demographics and practice situations," Bass said.
Partnership for Solutions, a program of the Robert Wood Johnson Foundation, the Health Resources and Services Administration and the National Heart, Lung and Blood Institute, sponsored the study.