This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Primary Care/ Family Medicine  • Quality of Care  • Quality of Care, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Siegel highlights an area of some confusion and controversy in the primary care redesign movement. One view holds that improving access to primary care visits will allow people with chronic illness to see their primary care clinician more promptly and thereby improve care for those who are chronically ill. I disagree with this view. I strongly believe that chronic illness care, especially higher-risk people, requires planned chronic care visits and close follow-up. If advanced access is implemented poorly, it could serve as a barrier to planned visits and frequent follow-up as Siegel fears. If advanced access is seen as only a first step in redesigning primary care (another step being the development of individual or group chronic-care-only visits, ideally with trained nursing personnel), and if clinicians are not discouraged from making appointments in advance for people with chronic illness, then better chronic care and better access could . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Advanced-Access Scheduling in Primary Care
Matthew Shuster
JAMA. 2003;290(3):332-333.
EXTRACT | FULL TEXT  

Advanced-Access Scheduling in Primary Care
David Siegel
JAMA. 2003;290(3):333.
EXTRACT | FULL TEXT  

Advanced-Access Scheduling in Primary Care—Reply
Mark Murray and Donald M. Berwick
JAMA. 2003;290(3):333.
EXTRACT | FULL TEXT