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The System Is Down

Nancy C. Elder, MD, MSPH; John Hickner, MD, MSc

JAMA. 2005;293:617-619.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In clinical medicine, the key to a successful patient-physician relationship is good communication. The ability to listen, explain, and empathize is as important as the ability to diagnose and treat. Why then, when it comes to communicating among ourselves, do physicians and health care organizations settle for mediocrity? Communication problems exist between specialists and primary care physicians,¹ the laboratory and physicians’ offices,^2-3 hospitalists and office-based physicians,⁴ the hospital and physicians’ offices,⁵ and nursing homes and physicians’ offices.⁶

In this issue of JAMA, Smith and colleagues⁷ describe the problem of missing clinical information during primary care visits and how these breakdowns in professional communication may adversely affect patient care. In 1 of 7 visits, some important piece of data—a laboratory result, a letter from a consultant, a radiology report, a hospital history and physical examination—was not available at the time the patient . . . [Full Text of this Article]

Author Affiliations: Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio (Dr Elder); Department of Family Medicine, The University of Chicago Pritzker School of Medicine, Chicago, Ill (Dr Hickner).

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Peter C. Smith, Rodrigo Araya-Guerra, Caroline Bublitz, Bennett Parnes, L. Miriam Dickinson, Rebecca Van Vorst, John M. Westfall, and Wilson D. Pace
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ABSTRACT | FULL TEXT  

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