Quite often, the “silos” in the health field – so often talked about in metaphor – are also quite literal. As one expert put it, “Space is a highly coveted resource,” and the result is that the very professionals who should be working together end up divided into separate locations and practices. For example, Dr. Chantelle Rice, an Occupational Therapist (OT) at USC, described the challenges of building relationships with primary care physicians when the USC OT practice is in an entirely separate building from the clinics where physicians practice. Encouraging referrals from primary care to OT is hard enough thanks to the separation, and even when patients are referred, the need to schedule and attend an entirely separate visit adds an extra barrier. As a result, many of the patients who would benefit most from an OT-supported lifestyle intervention are lost to follow-up, or never encouraged to meet with a well-matched specialist in the first place. Health centers that house primary care physicians, behavioral specialists, and other varying specialists – all under the same roof – can better facilitate coordination of care.
