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Workshop B - Ianice Robinson There were five threads that ran through much of the discussion in our group over the past couple of days. First, there was general consensus among the group about the value of community oriented primary care (COPC). However, a good deal of discussion centered around defining what is ac- tually meant by COPC. A second thread was concern over lack of epidemiologic data for planning services delivery through COPC or, at least, the lack of full exploitation of the data that may already exist. Thirdly, as has already been implied and in some cases explicitly stated in the major papers, participants in Workshop B expressed concern that the economic situation, which is difficult at best, in a very real way threatens those samples or models of COPC that already do exist, both in the services delivery arena and in the health education field. A fourth theme that coursed through the discussion was the need for some real emphasis on the cognitive preparation for providers who will, in fact, work in COPC. Finally, a fifth thread running through the discussion pertained tO the frequent mention, in the presentations, of COPC as a cost-effective mech- anism. This may be true, but it needs to be documented. The group felt strongly that a new discipline of COPC needs to be created. A number of specific suggestions emerged from the discussion. In an effort to address the issue of documenting the cost-effectiveness of COPC, it was suggested that an arbitrary number of sites (perhaps 25), already possessing most of the COPC elements, be identified and an economic and 285
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286 PART III: WORKSHOP DISCUSSION SUMMARIES epidemiologic evaluation be conducted using data that are already available. Half of these sites could be main stream and half could be from underserved areas. A broad range of geographic locations and practice models (solo, group, local health agencies, etc.) might be used. It would also be important to have multidisciplinary teams present at many of these sites. Use of the National Health Service Corps in this kind of effort was suggested. Another suggestion was aimed at provider preparation. The group pro- posed that several centers (perhaps four to six) be identified to develop programs specifically geared to training health care providers in COPC. This training should be based at several levels. The group felt strongly that such training not be dominated by medical schools. All efforts at developing COPC need to be coordinated, and training centers need to have access to the already-existing COPC centers discussed above. The workshop participants suggested that the concept of COPC be shared with the community. The sense was that if the people knew and agreed with the concept, COPC would have strong backing for funding proposals. In summary, the workshop proved to be a valuable opportunity for all in attendance to discuss and explore the concept of COPC in various models. Although more questions were generated than answers provided, it pro- vided a rekindling of excitement in the minds of many who have a strong dedication to the health care needs of our nation and who are interested in developing innovative ways of best meeting those needs for all people.