Table 2 Factors in clinical decision making in acute vs. chronic illness.

Nature of illness

Discrete; time-limited; treatable

Pervasive; long-term; manageable

Decisions

Cure focused

Control focused

Nature

Deal with cause; minimal side effects

Symptom reduction; sequellae prevention; side effects trade-off

Number

Single

Multiple; repetitive

Evidence used

Focused on illness

Focused on illness plus lifestyle; little on multiple chronic conditions and their interaction

Decision making relationship

Patient and treatment focused; Permission for provider to act

Consumer and symptom focused; Permission for consumer to act

Decision making environment

Temporary disruption until patient is well

Permanently altered to accommodate symptoms and management