Organization Of The Report

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.

References

Alpert, J.J., and Charney, E. The Education of Physicians for Primary Care. Publ. No. (HRA) 74-3113. Washington, D.C.: U.S. Department of Health, Education, and Welfare, 1973.


CCMC (Committee on the Costs of Medical Care). Medical Care for the American People: The Final Report of the Committee on the Costs of Medical Care. Publ. No. 28. Chicago: University of Chicago Press, 1932.

Coggeshall, L.T. Planning for Medical Progress Through Education. Washington, D.C.: American Association of Medical Colleges, 1965.

COGME (Council on Graduate Medical Education). Third Report. Improving Access to Health Care Through Physician Workforce Reform: Directions for the 21st Century. Rockville, Md.: Health Resources and Services Administration, Public Health Service, 1992.


IOM (Institute of Medicine). A Manpower Policy for Primary Health Care: Report of a Study . Washington, D.C.: National Academy Press, 1978.

IOM. Defining Primary Care: An Interim Report. M. Donaldson, K. Yordy, and N. Vanselow, eds. Washington, D.C.: National Academy Press, 1994.

IOM. The Nation's Physician Workforce: Options for Balancing Supply and Requirements. K.N. Lohr, N.A. Vanselow, and D.E. Detmer, eds. Washington, D.C.: National Academy Press, 1996a.

IOM. Nursing Staff in Hospitals and Nursing Homes: Is It Adequate? G.S. Wunderlich, F. Sloan, and C.K. Davis, eds. Washington, D.C.: National Academy Press, 1996b.



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