Inside a red-bricked building on the north side of Washington DC, internist Shantanu Nundy rushes from one examining room to the next, trying to see all 30 patients on his schedule. Most days, five of them will need to follow up with some kind of specialist. And odds are, they never will. Year-long waits, hundred-mile drives, and huge out-of-pocket costs mean 90 percent of America’s most needy citizens can’t follow through on a specialist referral from their primary care doc.

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