General Hospital Psychiatry
Volume 23, Issue 3 , Pages 138-144, May 2001

Rethinking practitioner roles in chronic illness: the specialist, primary care physician, and the practice nurse☆

  • Wayne Katon, M.D.

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Box 356560 University of Washington Medical School, Seattle, WA 98195, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-206-543-7177; fax: +1-206-221-5414
    • ,
  • Michael Von Korff (Sc.D.)

      Affiliations

    • Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA
    • ,
  • Elizabeth Lin, M.D. (M.P.H.)

      Affiliations

    • Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA
    • ,
  • Greg Simon, M.D. (M.P.H.)

      Affiliations

    • Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA

Abstract 

In this article, we describe an evidence-based stepped care approach to improving the care of chronic illness in organized health care systems. We review the common principles that have been found to improve the management and outcomes of patients with major depression, asthma, diabetes, and congestive heart failure. These population-based methods to improve care of chronic illness require reorganizing the roles of specialists, primary care physicians, and nurses.

Keywords:  Stepped care, Chronic illness

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☆ This work was supported by the National Institute of Mental Health Services Division, Rockville, M.D. [Grants #MH4–1739 and #MH 011643 (Dr. Katon)].

PII: S0163-8343(01)00136-0

General Hospital Psychiatry
Volume 23, Issue 3 , Pages 138-144, May 2001

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