Avril Swan, MD · Board-certified Family MedicineWhole Family MD ↗
Care coordination

You have five specialists. Who is keeping track of everything?

Specialists are often exactly what you need. The trouble starts when nobody is responsible for putting all of their recommendations back together.

One doctor may be following your heart. Another is thinking about your thyroid. Someone else ordered an MRI. A fourth changed a medication. Each decision may make perfect sense inside that specialty.

Your body does not divide itself into departments.

This is one of the jobs of primary care.

I want to know who you are seeing, why you are seeing them, what changed, and what still needs to happen. I want to notice when two plans collide or when everybody assumes somebody else is following the same result.

You should not have to keep track of everything by yourself.

Patients will always need to participate in their care. That is different from expecting them to maintain the master spreadsheet, reconcile every recommendation, and decide which doctor should own the next step.

The more complicated healthcare becomes, the more valuable it is to have one clinician who still knows the whole story.

The specialist owns a piece. Primary care should still own the thread.

How I practice