Lack of time | Probably the primary limitation is time which I think is most people’s primary limitation (specialist physician). |
Competing demands | … other issues that are the priorities, the other competing interests… there is a man that is coming this afternoon… he could die at any moment, and I don’t think he has any kind of advanced directives anywhere on his chart, and I’m his provider! So I feel kind of lame about that but there is always a crisis with him, there is always a crisis when he comes in so it’s one thing after another (primary care physician). |
Difficulties in provider coordination | I think primary care physicians don’t want to deal with these questions, we think they should be managed by the specialists because they are providing the specialty care (for a disease) that is going to kill them… I think very often the specialist thinks, well I have only known this patient a short time, the primary care doc should do this (primary care physician). |