“Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”

– Atul Gawande, Better: A Surgeon’s Notes on Performance

A recent perspective in the New England Journal of Medicine describes a general internist’s efforts to coordinate care. His patient, Mr. K., was a 70-year-old with probable cholangiocarcinoma. Over an 80-day period between identification of a mass on MRI and resection of the tumor, Dr. Press details 11 other clinicians involved in his patient’s care (note that the physician anesthesiologist was not identified in this group). Mr. K. had five procedures and 11 office visits. Dr. Press notes communication with other clinicians on 40 occasions and with his patient 12 times. How often this level of coordination occurs throughout our nation is a matter of debate, but few would disagree that when in...

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