This article reports three years of activity of the Johns Hopkins Self-Insured Workers' Compensation Program in the State of Maryland, USA. The occupational physician/nurse team coordinates the entire care-management system from prevention of accidents to facilitated return to work. The latter includes follow-up of workplace hazards and corrections of unfavourable ergonomic conditions. The decrease in claims and the significant savings achieved indicate the success of this integrated approach in a state where employees are free to choose their physicians.

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