A Manpower Policy for Primary Health Care Report of a Study (1978) / Chapter Skim
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Chapter 6: Conclusion: The Schedule of Implementation
Chapter 6: Conclusion: The Schedule of Implementation
Pages 93-104
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From page 93... ...
And because different forces and barriers affect in different ways the achievement of different proposals, the implementation periods will vary. Although there are differences in implementation, the recommendations of this report are linked with a common policy goal: an approrpiate supply of trained practitioners providing high-quality primary care to all populations in the country In the committees opinion, this goal is most likely to be attained if health policymakers adopt the entire strategy proposed in this report, rather than selecting only a few recommendations to implement.
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From page 94... ...
Public attention to the development of primary care manpower policy will help assure the linkage of that policy to improvements in the health care system. Recommendation #1 Because no practice arrangement has been found superior to any other, primary care as defined in this report should continue to be delivered by various combinations of health care providers in a variety of practice arrangements.
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From page 95... ...
Recommendation #3 For the present, the numbers of physician assistants and nurse practitioners trained should remain at the current annual level. Prerequisites: Acknowledgement that this is only a pause pending more information and monitoring of the following: the level of public demand for the provision of medical and other services by new health practitioners; the substitution of physicians by new health practitioners; and the productivity and flexibility of different interprofessional configurations and types of practitioners in serving different populations and meeting different needs.
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From page 96... ...
Time required: One to three years is required to institute change, although a generation may be required to complete the process by ending inappropriate financial discentives to primary care practice. Responsible groups: Health Care Financing Administration of DREW, state Medicaid authorities, fiscal intermediaries and insurance carriers in cooperation with hospitals, clinics, and other providers of care.
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From page 97... ...
Recommendation #7 Training programs for family physicians, nurse practitioners, and physician assistants should continue to receive direct federal, state, and private support, because these practitioners are the most feasible providers of primary care to underserved populations. Prerequisites.
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From page 98... ...
Recommendation #10 There should be an active, continuous program for monitoring a number of factors including the numbers and specialty and geographic distribution of physicians, nurse practitioners, and physician assistants, and also for monitoring the perceptions of the patient population regarding the adequacy and availability of primary care services. Prerequisites: Better coordination of health services ~ .
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From page 99... ...
Prerequisites: In the long run, more information about population needs for primary and non-primary care services, the productivity and geographic mobility of primary care physicians, the volume of primary care services provided by different physician specialties and different manpower configurations, and the effects of primary care residency training on physician decisions to limit their practice to primary care; in the short run, belief that most physicians should be primary care practitioners, that primary care physicians should receive specialty training in primary care, and that most physicians now in practice are not · _ e ~ e mainly primary care practitioners. Time required: One to three years.
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From page 100... ...
Recommendation #14 It is desirable that all medical schools direct or have a major affiliation with at least one primary care residency program in which residents have responsibility under faculty supervision for the provision of accountable, accessible, comprehensive, continual, and coordinated care. Prerequisites: Sufficient supply of primary care residency .
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From page 101... ...
Responsible croups: AAMC and medical schools; Liaison Committee on Medical Education; Bureau of Health Manpower of DHEW; potential federal., state, and private funder-s of programs in primary care clinical medical. education, including AHECs.
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From page 102... ...
Time required: Now to four years. Responsible croups: AAMC and medical schools; other health professions schools, graduate training institutions and educational organizations; accrediting bodies; Bureau of Health Manpower of DREW; potential federal, state and private funders of programs in primary care education.
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From page 103... ...
and training, in collaboration with physicians and other health professionals. Prerequisites: Acceleration of present efforts to develop more uniform standards for nurse practitioner education.
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