HE VALUE of comprehensive, long term medical care of the patient T with chronic joint disease is well known. The importance of fulfilling all the complex needs of the patient with any chronic disease such as rheumatoid arthritis has been stressed repeatedly in the literat~re.l-~ And yet we do nct find any discussion of the administrative problems attendant upon an exemplai y clinic-one that provides not only total care but also facilities for teaching and research. Our' attention was perforce directed to these problems during our own efforts to organize such a clinic in a teaching center. Some comments concerning our experiences, QUr solutions and our impressions, gained empirically, may save others a difficult trial-and-error period.
By comprehensive care in chronic arthritis we mean the prevention of disability, the provision for optimal physical restoration, for personal and emotional adjustment, and the provision for vocational guidance, training, and/or placement for all possible candidates. Thus we mean rehabilitation in the broadest sense. A major requirement for such long term medical care is that there be provision for special services entailing medical and paramedical personnel who, in an academic environment, must contribute to teaching and research as well as patient care.