How do you manage the growing expectation to handle specialty-level problems in primary care, such as dermatologic procedures, joint injections, or psychiatric medication management, when referral wait times are long and patients look to you to fill the gap?

Robust eConsult programs can make this dilemma much easier. Our specialty colleagues are troubled by the access issues as much as Primary Care in these situations, and utilizing this asynchronous option can empower the PCP and offload the specialists so they can prioritize the in-person slots for pa...

Doing these procedures in primary care speeds up treatment and diagnosis instead of waiting for a consult. Over the years, I have done shavings and biopsies and thousands of joint injections. If you are not comfortable with them, simple training is not difficult and is worth obtaining, as it can hel...

I think there is value in structuring a clinic to align provider interests with both patient needs and educational gaps, in a way that does not necessarily require every practitioner to be an expert in everything.

I am fortunate to be a part of a relatively large academic practice. I had more of an ...