Primary Care: America's Health in a New Era / Edition 1

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Overview

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base--as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers
  • The scope of primary care.
  • Its philosophical underpinnings.
  • Its value to the patient and the community.
  • Its impact on cost, access, and quality.
This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems--important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: David Meltzer, MD, PhD (University of Chicago Pritzker School of Medicine)
Description: This book reports the results of a study of the future of primary care by the Institute of Medicine (IOM). It begins by updating the definition of primary care developed by the IOM in 1978. It then proceeds to discuss the value and process of primary care, including chapters on primary care delivery, workforce, training, and research needs. It concludes with detailed recommendations to improve primary care and a discussion of challenges to their implementation.
Purpose: It is intended to provide a detailed definition of primary care and make policy recommendations to improve primary care in the United States.
Audience: Health policy specialists or physicians interested in primary care comprise the audience for this work.
Features: The most valuable section of the book is the chapter that defines primary care as "the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community." Although this definition is more a statement of a vision for the future of primary care than a description of primary care as it now exists, the definition describes several features of primary care that provide a valuable framework for analyzing its quality and working toward its improvement. The majority of the volume is then devoted to recommendations to improve primary care. Although no recommendation is made concerning the contentious issue of who should be considered a primary care physician, there are important recommendations concerning workforce policy, all-payer funding for graduate medical education, and the promotion of research in primary care.
Assessment: Perhaps reflecting its emphasis on defining an ideal model of primary care and making policy recommendations, the least satisfying part of the book is the chapter devoted to documenting the value of primary care, which relies heavily on anecdotes and contains only a brief and uncritical review of the academic literature. Although not as scholarly as more academic volumes such as Barbara Starfield's Primary Care, this IOM report devotes greater attention to constructing a policy agenda for primary care, and its recommendations are worthy of attention by policymakers and practitioners devoted to primary care. Because nearly every national health care organization of any note provided testimony for the study, the report is likely to be widely cited. The fact that those organizations and others providing testimony were generally given only 5 or 10 minutes to testify suggests there was little room to probe deeply into the most difficult issues in primary care. Accordingly, the report's recommendations for further research deserve high priority.
David Meltzer
This book reports the results of a study of the future of primary care by the Institute of Medicine (IOM). It begins by updating the definition of primary care developed by the IOM in 1978. It then proceeds to discuss the value and process of primary care, including chapters on primary care delivery, workforce, training, and research needs. It concludes with detailed recommendations to improve primary care and a discussion of challenges to their implementation. It is intended to provide a detailed definition of primary care and make policy recommendations to improve primary care in the United States. Health policy specialists or physicians interested in primary care comprise the audience for this work. The most valuable section of the book is the chapter that defines primary care as ""the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community."" Although this definition is more a statement of a vision for the future of primary care than a description of primary care as it now exists, the definition describes several features of primary care that provide a valuable framework for analyzing its quality and working toward its improvement. The majority of the volume is then devoted to recommendations to improve primary care. Although no recommendation is made concerning the contentious issue of who should be considered a primary care physician, there are important recommendations concerning workforce policy, all-payer funding for graduate medical education, and the promotion of researchin primary care. Perhaps reflecting its emphasis on defining an ideal model of primary care and making policy recommendations, the least satisfying part of the book is the chapter devoted to documenting the value of primary care, which relies heavily on anecdotes and contains only a brief and uncritical review of the academic literature. Although not as scholarly as more academic volumes such as Barbara Starfield's Primary Care, this IOM report devotes greater attention to constructing a policy agenda for primary care, and its recommendations are worthy of attention by policymakers and practitioners devoted to primary care. Because nearly every national health care organization of any note provided testimony for the study, the report is likely to be widely cited. The fact that those organizations and others providing testimony were generally given only 5 or 10 minutes to testify suggests there was little room to probe deeply into the most difficult issues in primary care. Accordingly, the report's recommendations for further research deserve high priority.
Booknews
Defines primary care and makes recommendations for improving its organization, financing, infrastructure, and knowledge base, looking at controversies such as the traditional relationship between patient and doctor, the philosophical underpinnings of primary care, the needs of special populations, and capitation. Includes numerous appendices of written statements and testimony from a December 1994 public hearing held by the Committee on the Future of Primary Care. Annotation c. Book News, Inc., Portland, OR (booknews.com)

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780309053990
  • Publisher: National Academies Press
  • Publication date: 9/5/1996
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 416
  • Product dimensions: 6.17 (w) x 9.29 (h) x 1.24 (d)

Table of Contents

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