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How Many Other Doctors Do Primary Care Doctors Need to Coordinate Patient Care With?
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What is the problem and what is known about it so far?
Primary care doctors, such as general internists, family doctors, and general pediatricians, provide general care rather than focus on a narrow area of medicine. A major role of primary care doctors is to coordinate care for their patients. This coordination often requires that primary care doctors interact with other doctors who care for the same patients. Little is known about the number of other doctors that a primary care doctor may need to interact with. This information would be useful in developing models that serve to improve patient care. Coordination of care is a major focus of the patient-centered medical home, a model of care that some experts are currently promoting as a way to improve the quality of care in the United States.
Why did the researchers do this particular study?
To estimate the number of other doctors that a primary care doctor may need to interact with in the care of patients for whom they are the primary care doctor.
Who was studied?
2284 primary care doctors who completed a 2004–2005 national survey of community doctors who serve Medicare patients.
How was the study done?
The researchers used Medicare billing data to identify patients for whom the surveyed doctors served as primary care doctors. They then collected information on the numbers of other doctors seen by each of the primary care doctor's patients.
What did the researchers find?
The typical primary care doctor has 229 other doctors working in 117 different practices that he or she may need to coordinate care with. In other words, for every 100 Medicare patients a primary care doctor sees, he or she may need to coordinate with 99 other doctors in 53 different practices.
What were the limitations of the study?
This study examined only Medicare patients, so it underestimates the total number of other doctors a primary care doctor would need to coordinate with. Surveyed doctors may also be different from doctors who did not complete the survey, and the data are from 2004 to 2005.
What are the implications of the study?
In caring for his or her own patients, a primary care doctor must coordinate care with many other doctors. Patients, doctors, and policymakers should seek ways to simplify coordination.
Article and Author Information
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The summary below is from the full report titled “Primary Care Physicians' Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination.” It is in the 17 February 2009 issue of Annals of Internal Medicine (volume 150, pages 236-242). The authors are H.H. Pham, A.S. O'Malley, P.B. Bach, C. Saiontz-Martinez, and D. Schrag.
