Restructuring Medical Education for Management of the Chronically Ill Aged*

ABSTRACT: The present system of medical education and practice often is more concerned with disease than with patients. Diagnosis‐oriented physicians usually have neither the inclination nor the training to be involved in the complex team system required in care of the chronically ill aged. The personalized patient‐physician contract tends to be deflected by preoccupation with laboratory and diagnostic procedures and the patient often is denied the supporting structure of the Aesculapian authority. A high level of medical care for the chronically ill aged requires a different type of physician, primarily oriented toward treatment and management. When the diagnosis‐oriented and the management‐oriented physicians are mutually supportive, the patient will be the beneficiary. The basis and the nature of a restructured medical educational curriculum are described.