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For me self management support is helping the patient to play an active role in their healthcare and to become a partner with the nurse and physician team instead of the recipient of care.

Hello Ms. Mason. How are you doing today? What can I do for you today? Things have changed since I was in medical school. It was the doctor who knew what was right for the patient and what the goals should be. Things are just different in a very good way. That now it's really sitting down with another human being and helping them identify what's important for them. Old school the magic started as soon as the doctor walked into the room. New school is the magic happens as soon as the patient steps in the door of the clinic. That talks about just the whole team effort and again that the patient is at the center.

The goal is for the patient to have a clear understanding of what's happening to their body and how the day to day activities impact their disease. Besides being a physician I'm an educator. If they have a good understanding of what's happening, they can do something to change their life.

I haven't had a cigarette in almost, I'm a couple of days short of two months. It's incredibly important for people to have a sense of being able to manage their own lives and that includes their wellness and their illness. And it's important for them to know that they are not their illness and that they're a whole person and that through that they can change their life … and everything can get better.

Everybody self manages whether it's in a positive way or not so positive way. Self management support, viewed narrowly, is setting a goal with a patient. Broadly, it's really building a support network with and around a patient. Specifics to doing that, we have a lot of tools. We have some goal sheets that we can use with patients where they can choose from a picture array of goals. Or come up with their own thing that is important to them.

When I'm working with patients to try to try to get them to take more responsibility for their own care, we have this huge list of medications and treatments that they do every day and they have to do it. We're the coaches. Here's what we'd like you to do, this is what would be best for your health. And then let's see how we can fit this in a day. We're going to have to work with Julia and her family.

Self management has always been part of what we do. The family is essential, both from start all the way through older adulthood in providing care, providing support, helping people transition to adulthood, and then staying healthy in adulthood, making big decisions, of which there are many in this disease. So we all value family involvement quite a bit.

We know that patients live with chronic illness such as diabetes, asthma on a daily basis. However they don't come to clinic, nor do they see their physicians or providers on a daily basis. So a lot of the things that we do teach them when they are here maybe three or four times a year has to basically stick with them 365 days a year. So self management support allows us to get patients to empower themselves, to remember the little steps, the little things that they have to utilize to get through every day.