Specialist management and coordination of "out-of-domain care".

Fam Med

Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.

Published: January 2004

Background And Objectives: Fifteen percent of Medicare patients receive care only from specialists. This has led to the supposition that there might be a "hidden system of primary care," where specialists provide comprehensive care to their patients, including care traditionally outside their specialty domain. This study explores the perspectives of specialists at an academic medical center on their decisions to provide "out-of-domain" care and how it is coordinated.

Methods: We used grounded theory methodology and a constant comparative process with 13 specialist interviews.

Results: Patient requests drive the provision of out-of-domain care. Specialist comfort with this care and desire to perform it are involved with their decision to provide out-of-domain care. Coordination of out-of-domain care performed by specialists can be difficult and time consuming but is important and is facilitated by electronic medical records.

Conclusions: The results suggest that there is no hidden system of primary care. Coordination among all providers of medical care for a patient is needed to prevent medical errors, especially when specialists provide out-of-domain care.

Download full-text PDF

Source

Publication Analysis

Top Keywords

out-of-domain care
16
care
11
system primary
8
specialists provide
8
provide out-of-domain
8
care coordination
8
specialists
5
specialist management
4
management coordination
4
coordination "out-of-domain
4

Similar Publications

Trauma is the leading cause of death in adults under the age of 45 and the fourth leading cause of death in the United States. Effective delivery of trauma care centers on being well versed in the Advanced Trauma Life Support (ATLS) protocol, which requires high levels of clinical experience. Often this comes from having been exposed to the many permutations of common types of injuries as well as exposed to rarer scenarios, but with potential harm to patients.

View Article and Find Full Text PDF

Background And Objectives: Fifteen percent of Medicare patients receive care only from specialists. This has led to the supposition that there might be a "hidden system of primary care," where specialists provide comprehensive care to their patients, including care traditionally outside their specialty domain. This study explores the perspectives of specialists at an academic medical center on their decisions to provide "out-of-domain" care and how it is coordinated.

View Article and Find Full Text PDF

The role of gynecologists in providing primary care to elderly women.

J Fam Pract

February 2001

Department of Family Medicine, School of Medicine, University of Washington, Seattle, USA.

Background: Federal legislation has recently been proposed to designate obstetrician-gynecologists (OBGs) as primary care physicians. The Institute of Medicine identifies care unrestricted by problem or organ system as an essential characteristic of primary care. We examined the degree to which OBGs in the state of Washington offer this aspect of primary care to their elderly patients by investigating the type and amount of nongynecologic care they provide.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!