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Editorial |

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

Alice Hm Chen, MD, MPH; Hal F. Yee Jr, MD, PhD
Arch Intern Med. 2009;169(11):1024-1026. doi:10.1001/archinternmed.2009.140.
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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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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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