Question special

Drs. Goroll and Hunt bring up an interesting idea of how primary care doctors can once again play a critical role for their patients once admitted. However, my patients seem to have a knack for getting admitted to multiple hospital systems. For example, I once had a patient admitted to all three hospitals in New Haven, CT - the VA hospital, a community hospital, and a tertiary academic center, all within the span of two months. How can I play a role in coordinating their care between those three facilities in today's disjointed health system? How can I find the time to make it to all three hospitals to see all my patients? Could we leverage our healthcare teams to provide that continuity of care?