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Primary Care, Generalism, Public Good: Déjà vu? Again!

2005; American College of Physicians; Volume: 142; Issue: 8 Linguagem: Inglês

10.7326/0003-4819-142-8-200504190-00018

1539-3704

Eric B. Larson, Kenneth B. Roberts, Kevin Grumbach,

Child and Adolescent Health

Editorials19 April 2005Primary Care, Generalism, Public Good: Déjà vu? Again!Eric B. Larson, MD, MPH, Kenneth B. Roberts, MD, and Kevin Grumbach, MDEric B. Larson, MD, MPHFrom Group Health Cooperative, Seattle, WA 98101-1448; University of North Carolina School of Medicine, Chapel Hill, NC 27401; and University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this author, Kenneth B. Roberts, MDFrom Group Health Cooperative, Seattle, WA 98101-1448; University of North Carolina School of Medicine, Chapel Hill, NC 27401; and University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this author, and Kevin Grumbach, MDFrom Group Health Cooperative, Seattle, WA 98101-1448; University of North Carolina School of Medicine, Chapel Hill, NC 27401; and University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-8-200504190-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Developing the supplement on the future of generalism in medicine in this issue caused us to have a collective sense of déjà vu (1-5). Many of the ideas and arguments presented in this supplement echo the calls for revitalization in recent “special reports” by groups in family medicine (6), pediatrics (7, 8), and internal medicine (9, 10) and harken back to the 1970s (11-13). During the reviewing and editing process, we felt like we have been through all this before. And, in fact, we have. Admittedly, there are important differences between the mid-1970s, when the primary care movement emerged (11), ...References1. Larson EB, Grumbach K, Roberts KB. The future of generalism in medicine. Ann Intern Med. 2005;142:689-90. LinkGoogle Scholar2. Ferrer RL, Hambidge S, Maly R. The essential role of generalists in health care systems. Ann Intern Med. 2005;142:691-9. LinkGoogle Scholar3. Stille CJ, Jerant A, Bell D, Meltzer D, Elmore JG. Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice. Ann Intern Med. 2005;142:700-8. LinkGoogle Scholar4. Weiner SJ, Barnet B, Cheng TL, Daaleman TP. Processes for effective communication in primary care. Ann Intern Med. 2005;142:709-14. LinkGoogle Scholar5. Schwartz MD, Basco WT, Grey MR, Elmore JG, Rubenstein A. Rekindling student interest in generalist careers. Ann Intern Med. 2005;142:715-24. LinkGoogle Scholar6. Martin JC, Avant RF, Bowman MA, Bucholtz JR, Dickinson JR, Evans KL, et al. The Future of Family Medicine: a collaborative project of the family medicine community. Ann Fam Med. 2004;2 Suppl 1 S3-32. [PMID: 15080220] CrossrefMedlineGoogle Scholar7. Halfon N, Olson LM. Introduction: results from a new national survey of children's health. Pediatrics. 2004;113:1895-8. [PMID: 15173459] MedlineGoogle Scholar8. Inkelas M, Schuster MA, Olson LM, Park CH, Halfon N. Continuity of primary care clinician in early childhood. Pediatrics. 2004;113:1917-25. [PMID: 15173462] MedlineGoogle Scholar9. Larson EB, Fihn SD, Kirk LM, Levinson W, Loge RV, Reynolds E, et al. The future of general internal medicine. Report and recommendations from the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine. J Gen Intern Med. 2004;19:69-77. [PMID: 14748863] CrossrefMedlineGoogle Scholar10. Larson EB. Health care system chaos should spur innovation: summary of a report of the Society of General Internal Medicine Task Force on the Domain of General Internal Medicine. Ann Intern Med. 2004;140:639-43. [PMID: 15096335] LinkGoogle Scholar11. Massachusetts Department of Public Health. The outpatient department— ambulatory care at the hospital. N Engl J Med. 1975;293:775. [PMID: 1160958] CrossrefMedlineGoogle Scholar12. Wasson JH, Sauvigne AE, Mogielnicki RP, Frey WG, Sox CH, Gaudette C, et al. Continuity of outpatient medical care in elderly men. A randomized trial. JAMA. 1984;252:2413-7. [PMID: 6481927] CrossrefMedlineGoogle Scholar13. Campion EW. Continuity counts [Editorial]. JAMA. 1984;252:2459. [PMID: 6481937] CrossrefMedlineGoogle Scholar14. Starfield B. Is primary care essential? Lancet. 1994;344:1129-33. [PMID: 7934497] CrossrefMedlineGoogle Scholar15. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Pr; 2001. Google Scholar16. Ginsburg PB. Payment and the future of primary care [Editorial]. Ann Intern Med. 2003;138:233-4. [PMID: 12558364] LinkGoogle Scholar17. Hsiao WC, Dunn DL, Verrilli DK. Assessing the implementation of physician-payment reform. N Engl J Med. 1993;328:928-33. [PMID: 8446140] CrossrefMedlineGoogle Scholar18. Schroeder SA, Sandy LG. Specialty distribution of U.S. physicians—the invisible driver of health care costs [Editorial]. N Engl J Med. 1993;328:961-3. [PMID: 8446146] CrossrefMedlineGoogle Scholar19. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA. 2003;290:1173-8. [PMID: 12952999] CrossrefMedlineGoogle Scholar20. Jolly P. Medical school tuition and young physician indebtedness. Washington, DC: Association of American Medical Colleges; 23 March 2004. Google Scholar21. Grumbach K. Primary care in the United States—the best of times, the worst of times [Editorial]. N Engl J Med. 1999;341:2008-10. [PMID: 10607821] CrossrefMedlineGoogle Scholar22. Whitcomb ME, Cohen JJ. The future of primary care medicine. N Engl J Med. 2004;351:710-2. [PMID: 15306674] CrossrefMedlineGoogle Scholar23. Wilensky GR. Reforming payment for primary care: making it happen [Editorial]. Ann Intern Med. 2004;140:662-3. [PMID: 15096342] LinkGoogle Scholar24. Feldbau G, Scott CM. Group Health Cooperative [Editorial]. Ann Intern Med. 2003;138:232. Google Scholar25. Halvorson G. Kaiser Permanente [Editorial]. Ann Intern Med. 2003;138:232. Google Scholar26. Carey S, McCartney S. Long flight: how airlines resisted change for 25 years, and finally lost; after deregulation; carriers failed to cut labor costs; Internet helps upstarts; US Airways' turbulent ride. Wall Street Journal. 5 Oct 2004:A1. Google Scholar27. Rice T. The Economics of Health Revisited. 2nd ed. Washington, DC: Health Administration Pr; 2003. Google Scholar28. Fisher ES, Welch HG. Avoiding the unintended consequences of growth in medical care: how might more be worse? JAMA. 1999;281:446-53. [PMID: 9952205] CrossrefMedlineGoogle Scholar29. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003;138:273-87. [PMID: 12585825] LinkGoogle Scholar30. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care. Ann Intern Med. 2003;138:288-98. [PMID: 12585826] LinkGoogle Scholar31. Larson EB. Medicine as a profession—back to basics: preserving the physician–patient relationship in a challenging medical marketplace. Am J Med. 2003;114:168-72. [PMID: 12586248] CrossrefMedlineGoogle Scholar32. Massachusetts Department of Public Health. The outpatient department—ambulatory care at the hospital. N Engl J Med. 1975;293:775. [PMID: 1160958] CrossrefMedlineGoogle Scholar33. Isaacs SL, Schroeder SA. Where the public good prevailed: lessons from success stories in health. The American Prospect. 4 June 2001:26-30. Google Scholar34. Gabow P. Denver Health. [Editorial]. Ann Intern Med. 2003;138:231-2. Google Scholar35. Hiatt HH. Protecting the medical commons: who is responsible? N Engl J Med. 1975;293:235-41. [PMID: 1143304] CrossrefMedlineGoogle Scholar36. Hardin G. The Tragedy of the Commons. Science. 1968;162:1243-8. [PMID: 9563937] CrossrefMedlineGoogle Scholar37. Stevens RA. The Americanization of family medicine: contradictions, challenges, and change, 1969-2000. Fam Med. 2001;33:232-43. [PMID: 11322514] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Group Health Cooperative, Seattle, WA 98101-1448; University of North Carolina School of Medicine, Chapel Hill, NC 27401; and University of California, San Francisco, San Francisco, CA 94110.Disclosures: None disclosed.Corresponding Author: Eric B. Larson, MD, MPH, Group Health Cooperative, Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448; e-mail, larson.[email protected]org.Current Author Addresses: Dr. Larson: Group Health Cooperative, Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448.Dr. Roberts: Pediatric Teaching Program, Moses H. Cone Health System, 1200 North Elm Street, Greensboro, NC 27401.Dr. Grumbach: Department of Family and Community Medicine, Family and Community Medicine, San Francisco General Hospital, Ward 83, 1001 Potrero Avenue, San Francisco, CA 94110. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Future of Generalism in Medicine Eric B. Larson , Kevin Grumbach , and Kenneth B. Roberts The Essential Role of Generalists in Health Care Systems Robert L. Ferrer , Simon J. Hambidge , and Rose C. Maly Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice Christopher J. Stille , Anthony Jerant , Douglas Bell , David Meltzer , and Joann G. Elmore Processes for Effective Communication in Primary Care Saul J. Weiner , Beth Barnet , Tina L. Cheng , and Timothy P. Daaleman Rekindling Student Interest in Generalist Careers Mark D. Schwartz , William T. Basco Jr , Michael R. Grey , Joann G. Elmore , and Arthur Rubenstein The Future of Generalism in Medicine Glenn S. Ross The Future of Generalism in Medicine C. Anderson Hedberg Metrics Cited byDigital health needs for implementing high-quality primary care: recommendations from the National Academies of Sciences, Engineering, and MedicineTraveling for Medical Care in a Global WorldPhysicians Should Be Civic Professionals, Not Just Knowledge WorkersAccess to and utilization of healthcare: the provider’s roleRedesigning Payment of Internal Medicine: A Financial ChallengeThe Future of Generalism in MedicineGlenn S. Ross, MD 19 April 2005Volume 142, Issue 8Page: 671-674KeywordsForecastingHealth careHospital medicineMedical servicesMotivationPopulation statisticsPrevention, policy, and public healthPrimary carePublic policy ePublished: 19 April 2005 Issue Published: 19 April 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...