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Coordinated care in primary care: how it works in smaller centers

MedExpress Team

Iwona Schymalla

Published March 28, 2024 09:45

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Iwona Schymalla's guest is Adam Boruch, MD, a family medicine specialist and co-chair of the coordinated care section of the Polish Society of Family Medicine.

You are the head of a small rural PCP, but also of a PCP in a not-so-large city. We've been discussing coordinated care for some time in the pages of Medexpress, wondering if this project, finally launched not so long ago, has a chance of success. How can coordinated care be implemented if the PCP has one, two or three doctors working there?

Coordinated care is a great opportunity for patients in rural areas, but also in the context of the development of the entire clinic, it is a patient-centric project. It puts the patient at the center, but also takes into account the demands or expectations of both the medical staff and the provider and payer. The idea behind coordinated medicine is that the patient gets comprehensive care and comprehensive diagnostics at his or her home, on site. And it doesn't require exceptional financial outlays at the outset just a very big organizational change. Also, the idea is not to consult each case with a specialist in a narrow field just to meet the patient's health needs right in the primary care setting. And a family medicine specialist and a nurse at the beginning, just to implement this, is completely sufficient.

And if a consultation with a specialist is needed do you have the opportunity and do you manage to get these specialists? The rates and valuations of their services are not very high.

The idea is not consultation per se, while it is necessary in many cases. We, as the Podlaskie Employers' Association Zielonogórskie Porozumienie Zielonogórskie, following the example of other provinces as well, have established cooperation with an entity where clinics are affiliated with our association and can safely use such consultation. I, on the other hand, also use my acquaintances, still from my student days. We have a cardiologist colleague who comes to us once in a while, i.e. once every 3-4 months, to consult patients. But we also use the telemedicine model. For example, a Holter ECG is put on a patient in our clinic. Then...

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