In a rapidly aging population, two-thirds of persons over the
age of 65 have multiple chronic conditions,1 which has provoked
urgent discussions of how society will provide for its
health care needs.2 The concept of an enabling society has been
suggested as one way to enhance the abilities of citizens with
chronic illness to successfully meet their own needs.3 Within
the context of health care, enablement has been referred to as
patient empowerment,4 self-management support (SMS),5 and
collaborative care.6 The New Model of Care for family practice,
for example, proposes a patient-centered team approach,7
which has been further elaborated into the concept of the
patient-centered medical home, which includes SMS as one of
its nine core components.8 Although the need to empower persons
with chronic illness is apparent, it is less clear what specific
steps health care providers can take to enhance
self-management among their patients.