All the forces outlined above—and indeed others not yet perceived—will shape primary care in ways that this committee cannot fully anticipate. They constitute, however, an important context for the information presented and the findings and recommendations offered in the remainder of this report.
Chapter 2 incorporates much of the committee's interim report defining primary care (IOM, 1994). Chapter 3 discusses the value of primary care as viewed from the perspective of the individual and the policymaker, and it makes extensive use of illustrative vignettes. The nature of primary care, using the committee's definition as an organizing framework and drawing from its workshop on the scientific basis of primary care, is explicated in Chapter 4. Chapter 5 addresses the organization and delivery of primary care from the perspective of several current trends: changes in organization and financing; rising use of teams; growing needs of underserved populations; increasing recognition of the need for strong relationships between primary care and public health, mental health, and long-term care; the increasingly complex and fragile role of academic medical centers; and the emerging emphasis on information about quality of care.
Chapter 6 describes the primary care workforce and calls attention to the need to address all components of that workforce in concert, and Chapter 7 focuses on education and training issues for primary care clinicians. Chapter 8 identifies high priority research topics and documents the need for developing the infrastructure to support research efforts in this field. Finally, Chapter 9 discusses critical steps in implementation of the committee's recommendations.
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