FIGURE 5-1 Cancer-related physician office visits made by adults (ages 25 and older), by specialty, United States, 2001-2002 (average annual, in millions).

their practices. There were 558.4 million visits made to primary care physician offices in 2002 (all ages), so again, the relative proportion of visits that are designated in NAMCS as cancer-related visits is small. The point of showing this contrast is to say that there is a larger holistic perspective that occurs in primary care. This notion of shared care is very prevalent across the spectrum of health conditions that primary care providers care for, not just cancer. Primary care providers report that other physicians share care for the patient’s problem in nearly one-in-five visits (18 percent) (Woodwell and Cherry, 2004).

We talk about shared care in the report and at this meeting as a new, evolving idea. How exactly would it work? Are the delivery systems available to do it? Whose role would it be to handle which aspects of care? Is the primary care provider capable of dealing with it? These issues are well traveled territory in the primary care world, because it is already done for a wide variety of conditions. There is a regular relationship of shared care between primary care providers and specialists that often works very well and has been in place for many years. In the management of coronary artery disease, primary care physicians and cardiologists work together regularly in well-coordinated systems. There are lots of exceptions, and I



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