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January 19, 1970

A Program for the Care of Patients With Chronic Diseases

Author Affiliations

From the Department of Medicine, University of Tennessee, College of Medicine, and the Medical Service, City of Memphis Hospitals (Dr. Runyan), and the Memphis and Shelby County Health Department (Dr. Phillips, Mrs. Herring, and Mrs. Campbell), Memphis.

JAMA. 1970;211(3):476-479. doi:10.1001/jama.1970.03170030068010

Neighborhood clinics staffed by public health nurses have provided medical care to patients with certain stabilized chronic diseases (primarily, cardiac disease, hypertension, and diabetes) since 1963. Recently revised medical policies permit the nursing staff to assume even greater responsibility in rendering service which has increased the effectiveness of the program. The current policies permit the nurses to make changes in therapy, as set forth in protocols for each disease category, based upon their own observations and judgment, and, in addition, prescribe symptomatic treatment for minor complaints. Patients are referred to the Medical Center whenever the nurse finds the patient's condition warrants it. This program provides medical care of good quality, conveniently, and at a nominal cost, yet the physicians' time is greatly conserved. Some aspects of the program may have a wide application.