Research ArticleOriginal Research
A Participatory Model of the Paradox of Primary Care
Laura Homa, Johnie Rose, Peter S. Hovmand, Sarah T. Cherng, Rick L. Riolo, Alison Kraus, Anindita Biswas, Kelly Burgess, Heide Aungst, Kurt C. Stange, Kalanthe Brown, Margaret Brooks-Terry, Ellen Dec, Brigid Jackson, Jules Gilliam, George E. Kikano, Ann Reichsman, Debbie Schaadt, Jamie Hilfer, Christine Ticknor, Carl V. Tyler, Anna Van der Meulen, Heather Ways, Richard F. Weinberger and Christine Williams
The Annals of Family Medicine September 2015, 13 (5) 456-465; DOI: https://doi.org/10.1370/afm.1841
Laura Homa
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
PhDRoles: Academic Authors
Johnie Rose
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MD, PhDRoles: Academic Authors
Peter S. Hovmand
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
PhDRoles: Academic Authors
Sarah T. Cherng
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MPHRoles: Academic Authors
Rick L. Riolo
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
PhDRoles: Academic Authors
Alison Kraus
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MSWRoles: Academic Authors
Anindita Biswas
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MA, MPHRoles: Academic Authors
Kelly Burgess
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Academic Authors
Heide Aungst
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MARoles: Academic Authors
Kurt C. Stange
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MD, PhDRoles: Academic Authors
Kalanthe Brown
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Margaret Brooks-Terry
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
PhDRoles: Patient, Caregiver, and Clinician Authors
Ellen Dec
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Brigid Jackson
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Jules Gilliam
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
George E. Kikano
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MDRoles: Patient, Caregiver, and Clinician Authors
Ann Reichsman
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MDRoles: Patient, Caregiver, and Clinician Authors
Debbie Schaadt
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Jamie Hilfer
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Christine Ticknor
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
PhDRoles: Patient, Caregiver, and Clinician Authors
Carl V. Tyler
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MDRoles: Patient, Caregiver, and Clinician Authors
Anna Van der Meulen
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
Roles: Patient, Caregiver, and Clinician Authors
Heather Ways
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MDRoles: Patient, Caregiver, and Clinician Authors
Richard F. Weinberger
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
MDRoles: Patient, Caregiver, and Clinician Authors
Christine Williams
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
RN, FNPRoles: Patient, Caregiver, and Clinician Authors

Article Information
vol. 13 no. 5 456-465
PubMed
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Online ISSN
History
- Received for publication July 7, 2014
- Revision received May 19, 2015
- Accepted for publication June 21, 2015
- Published online September 14, 2015.
Copyright & Usage
© 2015 Annals of Family Medicine, Inc.
Author Information
- Laura Homa, PhD, Academic Authors,
- Johnie Rose, MD, PhD, Academic Authors,
- Peter S. Hovmand, PhD, Academic Authors,
- Sarah T. Cherng, MPH, Academic Authors,
- Rick L. Riolo, PhD, Academic Authors,
- Alison Kraus, MSW, Academic Authors,
- Anindita Biswas, MA, MPH, Academic Authors,
- Kelly Burgess, Academic Authors,
- Heide Aungst, MA, Academic Authors,
- Kurt C. Stange, MD, PhD, Academic Authors⇑,
- Kalanthe Brown, Patient, Caregiver, and Clinician Authors,
- Margaret Brooks-Terry, PhD, Patient, Caregiver, and Clinician Authors,
- Ellen Dec, Patient, Caregiver, and Clinician Authors,
- Brigid Jackson, Patient, Caregiver, and Clinician Authors,
- Jules Gilliam, Patient, Caregiver, and Clinician Authors,
- George E. Kikano, MD, Patient, Caregiver, and Clinician Authors,
- Ann Reichsman, MD, Patient, Caregiver, and Clinician Authors,
- Debbie Schaadt, Patient, Caregiver, and Clinician Authors,
- Jamie Hilfer, Patient, Caregiver, and Clinician Authors,
- Christine Ticknor, PhD, Patient, Caregiver, and Clinician Authors,
- Carl V. Tyler, MD, Patient, Caregiver, and Clinician Authors,
- Anna Van der Meulen, Patient, Caregiver, and Clinician Authors,
- Heather Ways, MD, Patient, Caregiver, and Clinician Authors,
- Richard F. Weinberger, MD, Patient, Caregiver, and Clinician Authors and
- Christine Williams, RN, FNP, Patient, Caregiver, and Clinician Authors
- Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio (Homa, Rose, Biswas, Burgess, Aungst, Stange); System Dynamics Design Laboratory, George Warren Brown School of Social Work, Washington University, St Louis, Missouri (Hovmand, Kraus); Center for the Study of Complex Systems, University of Michigan, Ann Arbor, Michigan (Riolo); Cleveland, Ohio (Brown, Dec, Gilliam, Schaadt, Hilfer, Van der Meulen); Case Western Reserve University, Cleveland, Ohio (Brooks-Terrry, Ticknor); Metro-Health System, Cleveland, Ohio (Jackson); College of Medicine, Central Michigan University, Mount Pleasant, Michigan (Kikano); Neighborhood Family Practice, Cleveland, Ohio (Reichsman, Ways, Williams); Cleveland Clinic, Cleveland, Ohio (Tyler); Weinberger & Vizy, LLC (Weinberger).
- CORRESPONDING AUTHOR: Kurt C. Stange, MD, PhD, Department of Family Medicine & Community Health, Case Western Reserve University, 11000 Cedar Ave, Suite 402, Cleveland, OH 44106-3069, kcs{at}case.edu
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In this issue
The Annals of Family Medicine: 13 (5)
Vol. 13, Issue 5
September/October 2015
A Participatory Model of the Paradox of Primary Care
Laura Homa, Johnie Rose, Peter S. Hovmand, Sarah T. Cherng, Rick L. Riolo, Alison Kraus, Anindita Biswas, Kelly Burgess, Heide Aungst, Kurt C. Stange, Kalanthe Brown, Margaret Brooks-Terry, Ellen Dec, Brigid Jackson, Jules Gilliam, George E. Kikano, Ann Reichsman, Debbie Schaadt, Jamie Hilfer, Christine Ticknor, Carl V. Tyler, Anna Van der Meulen, Heather Ways, Richard F. Weinberger, Christine Williams
The Annals of Family Medicine Sep 2015, 13 (5) 456-465; DOI: 10.1370/afm.1841
A Participatory Model of the Paradox of Primary Care
Laura Homa, Johnie Rose, Peter S. Hovmand, Sarah T. Cherng, Rick L. Riolo, Alison Kraus, Anindita Biswas, Kelly Burgess, Heide Aungst, Kurt C. Stange, Kalanthe Brown, Margaret Brooks-Terry, Ellen Dec, Brigid Jackson, Jules Gilliam, George E. Kikano, Ann Reichsman, Debbie Schaadt, Jamie Hilfer, Christine Ticknor, Carl V. Tyler, Anna Van der Meulen, Heather Ways, Richard F. Weinberger, Christine Williams
The Annals of Family Medicine Sep 2015, 13 (5) 456-465; DOI: 10.1370/afm.1841
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