A 63-Year-Old Man With Multiple Cardiovascular Risk Factors and Poor Adherence to Treatment Plans

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This article explores why evidence-based medicine often fails and how primary care practices can offer self-management support.

It argues that many patients do not achieve adequate control of cardio-vascular risk factors, in part because the systems in which many physicians work do not allow sufficient time for physicians to provide evidence-based medicine at every visit for every patient, to make sure that patients understand the evidence, and to assist and encourage patients to incorporate the evidence into their lives. It argues that to remedy this situation, primary care practices need to be held responsible for performing these activities and reimbursed adequately to allow the practices to build care teams who can work with physicians to carry out this responsibility. 

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