#4-99E. Navigating Fragmented Care: The ROAM Model for Dual-Location Residents (JGFM, 2026)

How can primary care physicians maintain continuity of care for patients who divide their lives between two different geographic locations? As dual-location living becomes increasingly prevalent, it poses significant challenges to healthcare delivery and increases the risk of fragmented care. Addressing this, a recent study utilized the Delphi technique to establish a core competency list for general practitioners and family physicians managing these mobile patients. The most crucial clinical takeaway from this research is the formulation of the "ROAM" model—comprising the Recognition of dual-location context, Orchestration of care, Alignment of care plans, and Multicultural professionalism—which provides a vital framework to prevent care fragmentation. However, when critically appraising this study, clinicians must note that the expert panel predominantly consisted of physicians from resort areas in Nagano Prefecture, which may restrict the generalizability of these findings to other urban or distinct regional settings. Nevertheless, understanding these competencies is essential for modern practitioners. Integrating the ROAM model into daily practice equips physicians with practical tools to navigate complex care coordination, ensuring holistic, patient-centered care for individuals with fluid living arrangements.

Citation: Hirohisa Fujikawa. Developing a Competency List for General Practitioners/Family Physicians Providing Care for Dual-Location Residents: Expert Consensus via the Delphi Technique. Journal of General and Family Medicine. 2026. DOI: 10.1002/jgf2.70149

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