I think most patients will agree that their physician probably doesn't spend enough time educating them about their health conditions. It's really a shame, but ever since managed care (HMOs specifically) entered the world of health care, primary care physicians have gotten so busy. Some doctors are spending 5 minutes or less per visit, just so they can meet their "quota" for the day. Of course, I'm generalizing here and I know that many physicians out there do their best to spend ample time with patients. However, I also know that quite a few doctors are getting burned out and they no longer enjoy seeing patients because they feel so rushed.
If patients aren't getting educated about their condition from their doctor, then how are they learning critical self management principles? Do patients with diabetes get to spend time with a certified diabetes educator? What about heart failure patients who need some coaching on proper lifestyle measures? Are managed care health coaches doing their role in guiding high-risk patients?
Effective disease management requires collaboration among many parties: the patient, the healthcare provider(s), and even the payer.