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July 18, 2007

Changing the Organization of Health Care

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(3):286-288. doi:10.1001/jama.298.3.286-b

To the Editor: We think that the Special Communication by Drs Porter and Teisberg1 skirts around several central issues. First, how should medical practice be organized for patients with more than one medical condition? Coordinated care around a single condition can be powerful when there is only one dominant and well-defined problem, such as cancer or chronic kidney disease. But what about the common situation of a Medicare recipient with more than 10 conditions requiring care? Multiple related and unrelated diseases and comorbidities are increasingly frequent with an increasing elderly population.

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