Do team care arrangements address the real issues in the management of chronic disease?

• Care plans are a decade-old program for coordinating care of patients with chronic illness. • The program currently involves Team Care Arrangements (TCAs), which require all providers to agree on all management decisions contained in the plan. By contrast, conventional referral processes leave it to providers to exercise their judgement about the other providers to be involved. • TCA requirements make coordination unwieldy and lack an evidentiary basis. • More importantly, although care plans were introduced to encourage general practitioners to shift from an episodic to a global approach, they do not necessarily do this. • The care plan objective would be better served by the development of comprehensive patient summaries.