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June 8, 2009

Improving the Primary Care–Specialty Care Interface: Getting From Here to There

Arch Intern Med. 2009;169(11):1024-1026. doi:10.1001/archinternmed.2009.140

Ms Jones presents to her primary care physician (PCP), Dr Sanchez, with symptoms of persistent diarrhea. Using prereferral guidelines posted on his practice's electronic referral system, he rules out Clostridium difficile, other bacterial and parasitic infections, and celiac disease. He refers her to a gastroenterologist, Dr Lee, for further evaluation and possible colonoscopy. When Ms Jones arrives, Dr Lee reviews the electronic referral, which includes Dr Sanchez's contact information and consultative question along with the patient's relevant history and laboratory results. After assessing Ms Jones, Dr Lee discusses the risks and benefits of colonoscopy with her to further evaluate the diarrhea. After the visit, Dr Lee dictates a note outlining the findings of the patient's assessment and the recommendations to Dr Sanchez. Within 2 days, the note can be found in the electronic medical record that both physicians use.

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