The complexity of the United States health care delivery system and medical education programs presents a number of barriers to communication within the primary care setting. Effective communication is necessary for providing care that is both integrated across a patient's multiple providers and considers the patient in the context of family and community. This paper discusses a number of these challenges and provides a conceptual framework with four general recommendations for improving communication.
- Promote medical communication skills training
- Institutionalize the role of the primary care physician as a participant in all major medical decisions
- Disseminate information technology and establish a universally accessible medical record
- Mitigate external factors that disrupt communication in primary care such as disjointed reimbursement systems or changes in insurance status.