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J Ambul Care Manage. 2018 Oct/Dec;41(4):314-322. doi: 10.1097/JAC.0000000000000253.

Transitioning Patients From Specialty Care to Primary Care: What We Know and What We Can Do.

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Department of Social and Behavioral Sciences (Dr Ackerman) and Division of General Internal Medicine (Dr Gleason), University of California, San Francisco.


Growing demand for specialty care has resulted in longer wait times for appointments, particularly at US academic referral centers. A proportion of specialty visits are for routine follow-up care of stable problems, and there is evidence that primary care providers are willing and able to take responsibility for a significant proportion of these patients. However, little is known about how to transition care back to a referring primary care clinician in a manner that is acceptable to everyone involved. In this article, we describe social, legal, and financial barriers to effective care transition and propose communication strategies to overcome them.

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