Generalist Medicine and the U.S. Health System

Generalist Medicine and the U.S. Health System......Page 5
CONTENTS......Page 9
Sources......Page 15
The Authors......Page 19
The Editors......Page 23
Foreword......Page 25
Editors’ Introduction......Page 27
Acknowledgments......Page 31
SECTION ONE: PRIMARY CARE AND THE EDUCATION OF GENERALIST PHYSICIANS: PAST, PRESENT, AND FUTURE......Page 33
Editors’ Introduction to Section One......Page 35
1 Primary Care Medicine and the Education of Generalist Physicians......Page 37
2 Reconstructing Primary Care for the Twenty-First Century......Page 80
SECTION TWO: PRIMARY CARE AND THE ROLE OF GENERALIST PHYSICIANS......Page 107
Editors’ Introduction to Section Two......Page 109
3 The Ecology of Medical Care......Page 113
4 The Need for a New Medical Model: A Challenge for Biomedicine......Page 130
5 Meeting the Challenge of Family Practice (The Willard Committee Report)—Introduction......Page 149
6 The Generalist Function in Medicine......Page 160
7 General Internal Medicine at the Crossroads of Prosperity and Despair: Caring for Patients with Chronic Diseases in an Aging Society......Page 170
8 What Does Family Practice Need to Do Next? A Cross-Generational View......Page 177
9 Should There Be a Merger to a Single Primary Care Specialty for the Twenty-First Century? An Affirmative View......Page 194
10 The Generalist Role of Specialty Physicians: Is There a Hidden System of Primary Care?......Page 202
11 Primary Care and Health: A Cross-National Comparison......Page 219
12 Primary Care in a New Era: Disillusion and Dissolution?......Page 229
ABSTRACTS FROM THE LITERATURE......Page 242
13 Improving the Health Care Workforce: Perspectives from Twenty-Four Years’ Experience......Page 260
GRANT REPORT SUMMARIES FROM THE ROBERT WOOD JOHNSON FOUNDATION......Page 287
SECTION THREE: SUPPLY AND DISTRIBUTION......Page 293
Editors’ Introduction to Section Three......Page 295
14 Improving Access to Health Care Through Physician Workforce Reform: Directions for the Twenty-First Century—Findings......Page 297
15 A Manpower Policy for Primary Health Care: Introduction and Summary......Page 302
16 The Elusive Generalist Physician: Can We Reach a 50 Percent Goal?......Page 313
17 Economic and Demographic Trends Signal an Impending Physician Shortage......Page 326
18 The Ramifications of Specialty-Dominated Medicine......Page 341
19 Influence of Income, Hours Worked, and Loan Repayment on Medical Students’ Decision to Pursue a Primary Care Career......Page 345
20 Physicians and Rural America......Page 353
ABSTRACTS FROM THE LITERATURE......Page 363
21 Practice Sights: State Primary Care Development Strategies......Page 379
GRANT REPORT SUMMARIES FROM THE ROBERT WOOD JOHNSON FOUNDATION......Page 401
SECTION FOUR: EDUCATION AND TRAINING......Page 409
Editors’ Introduction to Section Four......Page 411
22 The Graduate Education of Physicians (The Millis Commission Report)—Chapter 5—Comprehensive Health Care......Page 413
23 The Education of Physicians for Primary Care (Excerpt): The Elements of a Successful Program......Page 428
24 Residency Training in Internal Medicine: Time for a Change?......Page 454
25 The Education of Pediatricians for Primary Care: The Score After Two Score Years......Page 472
26 Sustaining the Development of Primary Care in Academic Medicine......Page 477
ABSTRACTS FROM THE LITERATURE......Page 500
27 Influencing Academic Health Centers: The Robert Wood Johnson Foundation Experience......Page 516
GRANT REPORT SUMMARIES FROM THE ROBERT WOOD JOHNSON FOUNDATION......Page 530
SECTION FIVE: QUALITY AND COST......Page 535
Editors’ Introduction to Section Five......Page 537
Part A: Generalists and Specialists......Page 539
28 Comparing Generalist and Specialty Care: Discrepancies, Deficiencies, and Excesses......Page 541
ABSTRACTS FROM THE LITERATURE......Page 573
Part B: Nurse Practitioners and Other Nonphysician Practitioners......Page 591
29 Quality of Patient Care by Nurse Practitioners and Physician’s Assistants: A Ten-Year Perspective......Page 593
30 Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial......Page 615
ABSTRACTS FROM THE LITERATURE......Page 639
31 Support of Nurse Practitioners and Physician Assistants......Page 643
GRANT REPORT SUMMARIES FROM THE ROBERT WOOD JOHNSON FOUNDATION......Page 657
Name Index......Page 663
Subject Index......Page 671