A Proposed Care Model for Complex Chronic Condition: Multiple Chemical Sensitivity

One of the major challenges to delivering effective health care to patients with complex, chronic health problems is that health systems have been designed to deal with acute episodic illness. This has lead to increasing specialization in treatment of disease, focused on individual body systems and indeed one part of one organ. When a person becomes acutely ill and requires expertise that cannot be managed by a primary care physician they are referred for specialized care. As the population ages we are seeing more chronic health conditions which require long term management, often punctuated by episodes requiring acute care. As the burden of chronic disease has increased it has been recognized that management becomes more complex when there are interacting problems like hypertension, cardiac disease and diabetes. Individual "diseases" are more easily managed, but when there are multiple diagnoses, management becomes more difficult. Fortunately many of these chronic conditions have clear guidelines for monitoring and treatment, and even where there can be several problems in the same patient the guidelines are followed. However, patients who develop more difficult problems in more than one body system often end up with treatment from multiple specialists. Coordination of the efforts of the various specialists usually rests in the hands of primary care physicians, which presents many challenges In Canada, family physicians provide primary care and for the most part work independently, not within a team of other health professionals. Most family physicians have a heavy workload and usually see many patients during fairly short visits. Patients with multiple, interacting problems present a major challenge for family physicians When someone is chronically ill with multiple conditions, they often see different clinicians at different sites. This increases the risks of errors and of poor care coordination. Undoubtedly this increases suffering for the individual and higher health care costs for society. These issues have been recognized in the elderly population and the speciality of geriatrics has developed which specializes in the management of the frail elderly Frailty is more likely with more health problems or deficits

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