Fig. 2b
From: Discharging the complex patient - changing our focus to patients’ networks of care providers
Participant 25. The FP operates out of a teaching clinic, where the patient may see a resident, clerk or nurse practitioner at any given appointment (unless they request to see the FP, in which case they must wait weeks). While there are no issues regarding formal communication and relay of visit notes between the clinic and the patient’s specialists, the patient is not clear about who is to provide their main COPD care: their respirologist or FP. The patient feels that not being able to see the FP themselves consistently contributes to this lack of clarity. When at their clinic, the most consistent message is to defer to their respirologist for COPD management. By contrast, the respirologist only wants to see them following acute events. This patient has had numerous hospitalizations due to COPD exacerbations, and the hospital has become an important provider in their network of care