Saul J. Weiner, MD; Beth Barnet, MD; Tina L. Cheng, MD, MPH; Timothy P. Daaleman, DO
Acknowledgments: The authors thank Simon Auster, MD, JD, for many shared insights and for comments on drafts of the manuscript that led to substantive changes. They also thank Greg Makoul, PhD, for suggestions incorporated into the section on provider–patient communication.
Grant Support: By the Robert Wood Johnson Foundation Generalist Physician Faculty Scholars Program.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Saul J. Weiner, MD, University of Illinois at Chicago, 840 South Wood Street, M/C 718, Chicago, IL 60612; e-mail, email@example.com.
Current Author Addresses: Dr. Weiner: Departments of Medicine and Pediatrics, University of Illinois at Chicago, 840 South Wood Street, M/C 718, Chicago, IL 60612, and The Midwest Center for Health Services and Policy Research, Jesse Brown Veterans Affairs Medical Center, R&D (MC 151), 820 South Damen Avenue, Chicago, IL 60612.
Dr. Barnet: Department of Family Medicine, University of Maryland School of Medicine, 29 South Paca Street LL, Baltimore, MD 21201.
Dr. Cheng: General Pediatrics & Adolescent Medicine, Johns Hopkins University, 600 North Wolfe Street, Park 392, Baltimore, MD 21287.
Dr. Daaleman: Department of Family Medicine, University of North Carolina at Chapel Hill, CB #7595, Manning Drive, Chapel Hill, NC 27599-7595.
Communication in the delivery of health care services occurs along 2 axes: between providers and patients and among several providers. In primary care, a principle objective in the provider–patient relationship is facilitating whole-person care, which is care provided in the context of family and community. In addition, primary care emphasizes communication between the primary care physician and other providers with the goal of integrated care, or care provided in the context of a patient's overall health care needs. However, considering both the U.S. health care delivery system and medical education programs, several obstacles interfere with the necessary processes of communication. This paper addresses those obstacles with a conceptual framework for effective communication in primary care. Recommendations propose formalizing requirements for the exchange of information among providers, enhancing communication training, disseminating information technology, and mitigating external factors that disrupt communication in primary care.
Conceptual framework for communication with and without the obstacles to whole person, integrated patient care.
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Weiner SJ, Barnet B, Cheng TL, Daaleman TP. Processes for Effective Communication in Primary Care. Ann Intern Med. 2005;142:709–714. doi: 10.7326/0003-4819-142-8-200504190-00039
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Published: Ann Intern Med. 2005;142(8):709-714.
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