Many chronic illness have features that are best managed by a team of caregivers.It is usefull to have a leader of the team who can be the PCP or a specialist, but in could be a nurse manager or a social worker depending on what needs to be coordinated.If the medical care is complex, a physician or nurse will usually take responsibility to ensure communication between clinicians.
Case management of complex medical problems has advantages.It improvers of communication and makes it easier to provide the necessary services.This becomes incresaingly important as managed care impacts access to care.The case manager can be the advocate of the patient and family and this role has been incorporated into Public Law 99-457, the Early Intervention Program for Infants and Toddler with Handicaps.
Primary care providers who are responsible for the care of children need to consider the role that is in the best interest of the child.They should consider their role, as well as how the various caregivers should inter-relate.They need to ensure that the family is aware of the many options available.
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