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A Typology of Specialists' Clinical Roles
Abstract
High use of specialist physicians and specialized procedures coupled with low exposure to primary care are distinguishing traits of the US health care system. Although the tasks of the primary care medical home are well established, consensus on the normative clinical roles of specialist physicians has not been achieved, which makes it unlikely that the specialist workforce is being used most effectively and efficiently. This article describes a typology of specialists' clinical roles that is based on the conceptual basis for health care specialism and empirical evaluations of the specialty referral process. The report concludes with a discussion on the implications of the typology for improving the effectiveness and efficiency of the primary-specialty care interface.
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Metadata
- Authors
- Forrest, C. B.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Christopher B Forrest
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-06-08
- Volume
- 169
- Issue
- 11
- Pages
- 1062
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1576730632
- Cited by
- 111
- References
- 0
- Citations by year
- 2024: 6 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 9 · 2019: 7 · 2018: 11 · 2017: 5 · 2016: 11 · 2015: 13 · 2014: 8 · 2013: 6 · 2012: 5
- FWCI
- 14.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Technology
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- patient-centered medical home, specialist workforce, health care utilization
- MeSH terms
- Communication, Continuity of Patient Care, Humans, Interprofessional Relations, Medicine, Physician's Role, Physicians, Family, Referral and Consultation, Specialization, Medical Records Systems, Computerized, Telemedicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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