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September 1, 2004

Chronic Disease—The Need for a New Clinical Education

Author Affiliations

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

JAMA. 2004;292(9):1057-1059. doi:10.1001/jama.292.9.1057

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.

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