BMJ 2000;320:569-572 ( 26 February )

Education and debate

The role of patient care teams in chronic disease management

Edward H Wagner, director. 

W A MacColl Institute for Healthcare Innovation, Center for Health Studies, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1290, Seattle WA 98101, USA

wagner.e@ghc.org

The first 150 words of the full text of this article appear below.

"In the gradual division of labor, by which civilization has emerged from barbarism, the doctor and nurse have been evolved"

Sir William Osler (1891)

The delivery of health care by a coordinated team of individuals has always been assumed to be a good thing. Patients reap the benefits of more eyes and ears, the insights of different bodies of knowledge, and a wider range of skills. Thus team care has generally been embraced by most as a criterion for high quality care. Despite its appeal, team care, especially in the primary care setting, remains a source of confusion and some scepticism.¹ Which disciplines are essential on the team? What do the team members other than the doctor do to support patient care?

With the ageing of the population and the advances in the treatment of chronic diseases, teamwork in the context of chronic diseases needs to be re-examined. Successful chronic . . . [Full text of this article]

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