1. This article examines the teams that emerge when a primary care physician (PCP) refers patients to specialists.
2. The authors constructed a new measure of PCP team referral concentration and found that it varies widely across PCPs, even among those in the same organization.
3. Chronically ill patients treated by PCPs with higher team referral concentration had 4% lower healthcare utilization on average, with no discernible reduction in quality.
The article is generally reliable and trustworthy, as it provides evidence from two different sources – the Massachusetts All Payer Claims Database and a national sample of Medicare claims – to support its findings. The authors also provide various identification strategies to account for observed and unobserved patient and physician characteristics, which further strengthens their argument. Furthermore, the article does not appear to be one-sided or promotional in nature; rather, it presents both sides of the argument equally and objectively.
However, there are some points of consideration that are missing from the article. For example, while the authors note that repeated interactions between PCPs and specialists can improve team performance, they do not explore any potential risks associated with this approach or discuss any counterarguments that could be made against it. Additionally, while the authors provide evidence for their claims from two different sources, they do not provide any evidence for how these results may apply to other contexts or settings outside of healthcare referral networks. Finally, while the authors note that there was no discernible reduction in quality associated with higher team referral concentration among chronically ill patients, they do not provide any evidence regarding whether this holds true for other types of patients as well.