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Despite increased emphasis on primary care in the United States, most care continues to be provided by specialists. The extent to which specialists incorporate elements of primary care in their approach to ambulatory patients is unknown.

To examine the extent to which selected medical and surgical subspecialties provide generalist care to Medicare patients, and to compare patterns of care between specialists and generalists.

A cross-sectional study of all ambulatory care recorded in Part B of the Washington State Medicare Claims Database in 1994 and 1995.

Ambulatory practices in Washington State.

Medicare beneficiaries 65 years or older who made office visits to the study physicians.

The extent to which individual specialties accounted for the majority of visits made by patients to physicians (a measure of continuity), provided care outside the …