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A Shared Destiny: Community Effects of Uninsurance
trained in a certain branch of medicine or dentistry related to specific services or procedures (e.g., surgery, radiology, pathology); certain age categories of patients (e.g., geriatrics); certain body systems (e.g., dermatology, orthopedics, cardiology); or certain types of diseases (e.g., allergy, periodontics). Specialists usually have advanced education and training related to their specialties. *
Services provided by medical specialists who generally do not have first contact with patients (e.g., cardiologists, urologists, dermatologists). In the United States, there has been a trend toward self-referral by patients for these services, rather than referral by primary care providers. *
Services provided by highly specialized providers (e.g., neurologists, thoracic surgeons, intensive care units). Such services frequently require highly sophisticated equipment and support facilities. The development of these services has largely been a function of diagnostic and therapeutic advances attained through basic and clinical biomedical research. *
Service provided by physicians and hospitals for which no payment is received from the patient or from third-party payers. Some costs of these services may be covered through cost shifting. Not all uncompensated care results from charity care. It also includes bad debts from persons who are not classified as charity cases but who are unable or unwilling to pay their bills. *