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Semin Med Pract 
2005 ;8:43-54
Effective physician approaches to support self-management
Heisler, M

Explosive growth in the number of people affected by chronic disease poses huge challenges for physicians and health systems. Unfortunately, physicians have not traditionally received much formal training in the skills and strategies necessary to be effective coaches to their patients with chronic illness. However, the ACGME requirement for communication competence underscores the importance of acquiring these skills. This article examines the critical foundations for effective patient management of chronic diseases, with a focus on the role of health care providers and the specific communication skills physicians should seek to develop and hone. Using the scenario of a patient with poorly controlled diabetes, hypertension, and hyperlipidemia, the author outlines a useful framework for effective behavioral counseling that can be applied in short office visits to provide self-management support for patients.

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