What are FIRMs?
Firms have mostly started for reasons other than research. They are seen where there are large volumes of patients coming for care to one institution. In large urban teaching hospitals, where care has been provided by residents and subspecialty clinics have multiplied, the patient never saw the same doctor twice, the resident physicians never saw the outcome of the care they provided, and there was no coordination or continuity of care across many subspecialty units. This situation argued for creating teams of generalist providers of care out of a large amorphous clinical service. These teams would include residents, attending physicians, nurses, and other ancillary staff. Because this group would work together, they would know each other’s work habits. Patients were assigned to one of these groups and therefore have a greater change of seeing the same physicians and staff over time. These teams have been created in inpatient units, outpatient units, or both. Attending physicians assig
