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Supplement: The Future of Generalism in Medicine |

Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice

Christopher J. Stille, MD, MPH; Anthony Jerant, MD; Douglas Bell, MD, PhD; David Meltzer, MD, PhD; and Joann G. Elmore, MD, MPH
[+] Article and Author Information

From University of Massachusetts Medical School, Worcester, Massachusetts; University of California, Davis, Sacramento, and University of California, Los Angeles, Los Angeles, California; University of Chicago, Chicago, Illinois; and University of Washington, Seattle, Washington.


Acknowledgments: The authors thank Kurt Stange, MD, PhD; Richard Wasserman, MD, MPH; and Kenneth Roberts, MD, for thoughtful advice and review of early drafts of the manuscript.

Grant Support: In part by the Robert Wood Johnson Foundation Generalist Faculty Scholars Program (grant 42206) and the National Center for Research Resources (grant G12 RR 03026-13).

Potential Financial Conflicts of Interest: None disclosed.

Corresponding Author: Christopher Stille, MD, MPH, Division of General Pediatrics, University of Massachusetts, Benedict A3-125, 55 Lake Avenue North, Worcester, MA 01655; e-mail, stillec@ummhc.org.

Current Author Addresses: Dr. Stille: Division of General Pediatrics, University of Massachusetts, Benedict A3-125, 55 Lake Avenue North, Worcester, MA 01655.

Dr. Jerant: Family Medicine, University of California, Davis, School of Medicine, University of California Davis Medical Center, 4860 Y Street, Suite 2300, Sacramento, CA 95817.

Dr. Bell: Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, 911 Broxton Plaza, Room 314, Los Angeles. CA 90095-1736.

Dr. Meltzer: General Internal Medicine, Department of Economics, University of Chicago, 5841 South Maryland, MC 207, B220, Chicago, IL 60637.

Dr. Elmore: General Internal Medicine, Harborview Medical Center, Mailbox 359780, 325 Ninth Avenue, Room 10EH03, Seattle, WA 98104.


Ann Intern Med. 2005;142(8):700-708. doi:10.7326/0003-4819-142-8-200504190-00038
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The goal of coordination of medical care is to support patients and their families in their efforts to receive effective health care from an increasingly complex health care system. Coordination involves “the regulation of diverse elements into an integrated and harmonious operation” (1). Starfield (2) describes the essence of health care coordination as “the availability of information about prior problems and services and the recognition of that information as it bears on needs for current care.” This information includes knowledge about patients and families, and their experiences with and responses to health care. Ideally, information is made available through easily accessible medical records; written and verbal communication among clinicians, patients, families, and community resources; and clinicians' knowledge gained from past experiences with patients.

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