Promising ideas should periodically be re-evaluated. A demotion in enthusiasm may be due. Take primary care integration. Expectations have been great for its many versions over the years. However, a fairly limited scope has delivered modest benefits. It may be time for a transformative approach. A bold model will be described hereafter highlighting the limitations of current approaches.
When two complex entities like primary care and behavioral care are integrated, how much should either change? Sometimes integration just means coordination, and coordination suggests little change. For example, we coordinate care to avoid duplicative or conflicting interventions. There could be some changes in plans based on information exchange, but only occasionally.
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