With the growing elderly population and advances in medical technology, more people are diagnosed with and living with chronic diseases. Learning to manage multiple chronic diseases is challenging for physicians to learn, and even more challenging for our patients to undertake. Chronic disease management is often the focus of visits to the hospital or clinic, leaving little time, and even less skill, in the promotion of health in health care. To maximize effectively partnering patients and physicians to achieve the common goal of efficient chronic disease management and quality of life and function requires highly refined communication skills and activated patients, often involving partnering with lay members of a support system who are not traditionally present in the standard hospital or clinic visit setting. Further, promotion of health involves an understanding of and ability to maximize the social determinants of health, yet with the bulk of physician training seated in the hospital and clinic setting, few physicians have the opportunity to garner this more complete understanding of some of the most potent barriers and facilitators of health. 

© Medicine for the Greater Good Johns Hopkins 2014