The traditional history and physical examination provide only limited information about problems of physical, psychological and social function. Furthermore, traditional therapeutic techniques are not designed to foster full patient participation in improving functional status. The methods of detection, diagnosis and treatment of functional limitations discussed in this article were developed to meet the needs of the ever-increasing population of patients with chronic illnesses, among whom limitations of functioning have major long-term effects. The authors realize that they may be proposing an increase in the amount of time spent with each chronically ill patient. They also expect, however, that using these methods will increase the effectiveness of many physicians who are interested in devoting attention to improving patients' function. Success will depend on a patient's willingness to participate, resources and a physician's ability to use the suggestions.
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