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EDITORIAL Getting From Here to There S JONES PRESENTS TO HER PRIMARY CARE ATTENTION TO THE physician (PCP), Dr Sanchez, with MEDICAL NEIGHBORHOOD symptoms of persistent diarrhea. Using prereferral guidelines posted on The ability to implement the proposed typology de- M his practice’s electronic referral sys- pends on patients having a medical home, or at least a tem, he rules out Clostridium difficile, other bacterial and PCP. This has not been true for many Americans. Of Medi- parasitic infections, and celiac disease. He refers her to a care beneficiaries, only about 14% see a specialist for care gastroenterologist, Dr Lee, for further evaluation and pos- during a 1-year period. Indeed, access to specialty care sible colonoscopy. When Ms Jones arrives, Dr Lee re- has been considered a patient right and, more recently, views the electronic referral, which includes Dr Sanchez’s an issue of consumer choice, with patients purchasing contact information and consultative question along with health insurance coverage that allows more direct access the patient’s relevant history and laboratory results. Af- to specialists. Nonetheless, there is a movement afoot ter assessing Ms Jones, Dr Lee discusses the risks and ben- to give the medical home a central role in
JAMA Internal Medicine – American Medical Association
Published: Jun 8, 2009
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