Summary: Involving physicians and nurses in an initiative that teaches patients how to manage their own care may initially increase the demand on an already overtaxed primary care system, says Christopher Wise, administrative director of the Medical Management Center at the University of Michigan (U-M) Health System. But ultimately, the patient who better understands the intricacies of their disease and available care alternatives will actually have fewer reasons to access primary care physicians, he adds. In U-M's model, he explains, social workers and nurses who know the university's health services best function as health navigators, helping the chronically ill find their way through the system. For optimum efficiency and results, the patient's self-management must be linked to a broader aspect of the physician's office and the medical home it provides. Margaret Brennan, administrator for the Primary Care Access Network with Orange County Government, Maureen Kersmarki, board chair of the Primary Care Access Network for Florida Hospital along with Wise, described how their respective organizations have created sustainable partnerships for increasing access to primary care during a May 16, 2007 audio conference, Strategies to Increase Primary Care Access, Use and Coordination.
