Most doctors work alone when caring for patients -- a long tradition reinforced by the notion of a private doctor-patient relationship and by the way doctors are paid.
But new efforts nationally and in Minnesota are trying to change that. The notion is that closer collaboration among primary care doctors and specialists can improve care and cut costs.
Twin Cities doctors appear to be doing more of this "patient sharing" than physicians in other areas, according to a study this week in the Journal of the American Medical Association.
Twin Cities physicians not only share patients but cross hospital lines to do so, in part because major hospitals and specialists here are clustered closer than those in other cities, the researchers said.
The analysis was based on a study of records for 4.6 million Medicare beneficiaries seen by 68,288 physicians in 51 regions, including 596 doctors in the Minneapolis-St. Paul area.
Such sharing of patients, who often see multiple specialists for different ailments, can lead to better health and lower costs when the medical work is closely coordinated to minimize wasteful procedures and keep patients engaged.
Those also are primary goals of Minnesota's effort to build "health care homes," which so far has certified more than 170 clinics serving 2 million patients as able to offer more intensive care coordination. It's also a core part of developing "accountable care organizations" that will offer comprehensive care for a flat fee instead of a fee for each episode of care.
While the new study finds contact among doctors varies greatly by region, many questions remain about the type and quality of information doctors share, the authors said.
But the emphasis on sharing more information appears on target, an accompanying editorial noted: "More collaborative models of care will help both physicians and patients when the examination room door closes."
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