ZuWallack - Figure 47
Summary: Pulmonary Rehab and Good Medical Care
In summary, this presentation has focused on some aspects of the concept of pulmonary rehabilitation. Pulmonary rehabilitation is not available everywhere, and to conclude I would like to focus on the metaphysics of pulmonary rehabilitation. You recognize the image you see in this Figure as a motorcycle, not as handlebars, windshield, wheels, carburetor, etc; you see the whole package. Pulmonary rehabilitation is comprised not of carburetors, wheels, windshield, etc., but of the components listed on the left side of this Figure. Pulmonary rehabilitation comprises promotion of a healthy lifestyle, physical activity, regular exercise training, optimization of medical therapy, improvement of adherence to medical interventions, development of self-management plans, promotion of advanced directives, palliation of symptoms, and hopefully reduction of healthcare utilization. We can look on all these interventions as components of good medical care that as clinicians we should do, but maybe will not be able to do in a 15-min, 30-min, or 1-hour intervention. It is too much to fit all this into one short visit. Pulmonary rehabilitation as a package dealing with all these interventions, as the example of a motorcycle rather than its individual parts, is very important. None of these elements is individually much different from what can be done in medical practice; but it is much easier to combine them as an intervention and have them provided to patients by a qualified interdisciplinary team that is committed to the time with the patient needed for this intervention.
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