Only You Can Prevent Forest Fires (Chronic Pain & Self-Management)

this article originally appears on The A&G Project

Chronic pain is an epidemic.

Not only is this a problem for the individuals who suffer from pain, but also for our society.

The economic costs of inefficient care and failed short-term treatment plans have led to an inefficient healthcare system.  Worse, these short-term passive pharmaceutical solutions have destroyed the lives and communities of many.

As a society we need to look at chronic pain through a different lens.  One that incorporates the complexity of the situation and the realistic length of care.

To accomplish this, our focus needs to change.  Instead of the clinician providing a short term solution and patient receiving a passive fix, healthcare should focus on clinician led education and active patient self-management.

Clinical experience and current research show that outcomes are directly correlated with patient self-efficacy and compliance.  With the perspective of the clinician as a teacher or guide, the patient is encouraged to adopt the active role in their recovery and lifestyle that will lead to better outcomes.  This is not only much more effective, but also more efficient.

In a powerful article, Holman and Lorig suggest a 3 fold change in our healthcare system:

“The prevalence of chronic disease and the scope of its consequences have created a dramatically new situation in health care. Patients, health professionals, and the health service must now play new roles:

1. The patient—who must be responsible for daily management, behavior changes, emotional adjustments, and accurate reporting of disease trends and tempos—becomes the principal caregiver. Expressed in economic terms, health is the product of health care, and the patient, as a principal caregiver, is a producer of health. As in any production system, a producer must be knowledgeable about the product and skilled in the production process.

2. The health professionals, in addition to being professional advisers and partners in the design and conduct of medical management, become teachers in developing the patient’s management skills. In the present system, physicians, nurses, and public health workers are not trained for this role.

3. The health service becomes the organizer and financial supporter of the new roles for the patient and health professionals, focusing on assuring continuity and integration of care.”


The path to changing our healthcare system and our nation’s health is already available.  We just need both the medical practitioners and the patients to get on board.

Medical practitioners need to stop looking for short-term solutions and acknowledge the complexity of an individual’s health.

Patients need to stop looking for passive solutions and become an active leader in managing their health.

At The A&G Project in Asheville, we use this philosophy with all our patients.  It’s the Jerry MaGuire philosophy.  Less volume of patients.  More individualized care.  And a focus on giving you the tools to manage your health so that you can achieve the best quality of life possible.


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