7.6 Support for Graduate Medical Education in Primary Care Sites

The committee recommends that a portion of the funds for graduate medical education be reallocated to provide explicit support for the direct and overhead costs of primary care training in nonhospital sites such as health maintenance organizations, community clinics, physician offices, and extended care facilities.

7.7 Interdisciplinary Training

The committee recommends that (a) the training of primary care clinicians include experience with the delivery of health care by interdisciplinary teams; and (b) academic health centers work with health maintenance organizations, group practices, community health centers, and other health care delivery organizations using interdisciplinary teams to develop clinical rotations for students and residents.

7.8 Experimentation and Evaluation

The committee recommends that private foundations, health plans, and government agencies support ongoing experimentation and evaluation of interdisciplinary teaching of collaborative primary care to determine how such teaching might best be done.

7.9 Retraining

The committee recommends that (a) curricula of retraining programs in primary care include instruction in the core competencies proposed for development in Recommendations 7.2 and 7.3 and (b) certifying bodies in the primary care disciplines develop mechanisms for testing and certifying clinicians who have undergone retraining for primary care.

Chapter 8

8.1 Federal Support for Primary Care Research

The committee recommends that (a) the Department of Health and Human Services identify a lead agency for primary care research and (b) the Congress of the United States appropriate funds for this agency in an amount adequate to build both the infrastructure required to conduct primary care research and fund high-priority research projects.

8.2 National Database and Primary Care Data Set

The committee recommends that the Department of Health and Human Services support the development of and provide ongoing support for a national database (based on a sample survey) that reflects the majority of health care needs in the United States and includes a uniform primary care data set based on episodes of care. This national survey should capture data on the entire U.S. population, regardless of insurance status.

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