To the Editor.—
After supervising a training program for five years, we have a few suggestions to help house staff assume care for ambulatory patients. Our suggestions relate to encounters we found to be most problematic—those between a patient previously seen in the practice who is returning for continued care and new first-year residents.
Think of the first encounter between yourself and the patient as an acquaintance visit.
Review the patient's records beforehand. Pay particular attention to progress notes from the last few visits for the patient's most recent and active problems; note any plans or contracts made.
Recognize that the transfer of patient care is a process that takes time and cannot be jammed into one visit.
Introduce yourself as a new physician; acknowledge that the patient is returning for follow-up care and ask if there are any new problems.
Describe your objectives for