Benefits of primary care

Social Science & Medicine. Part C: Medical Economics, 1980

In the current debate over how lo utilize most effectively and efficiently resources lo improve the health of populations in developing countries, the usual approach by those who would argue for heavy investment in Primary Health Care (PHC) is lo compare and contrast the Cost-elTectiveness and cost-benefits of PHC versus alternative approaches While this paper touches upon the relative merits of PHC in contrast lo alternative approaches. it focuses more centrally on the need lo move from thinking about these as if they were mutually exclusive alternatives. and toward greater attention lo the proper balance among these alternatives. The debate over the investment in PHC as "the wave of the future" is or ought lo be, a debate concerning mix, timing and emphasis. The paper also argues for expanding the realm of inquiry to include issues of sociopolitical motivation-factors which have too long been neglected in more purely technical approaches lo the topic. Finally, the paper seeks lo identify and explore resource requirements for and constraints lo global expansion of PHC over the next 20 years and proposes specific principles lo guide development of PHC strategies.

Primary Care [Working Title], 2021

Family practice was recognized as the 20th specialty in American medicine in 1969. With the hope that primary care would become the foundation of an improved health care system, vigorous efforts were launched in medical education, research and practice to achieve that goal. This chapter traces the history of that effort, together with negative system changes that have obstructed that goal. Although primary care physicians have been shown to improve access to care, contain costs, decrease inequities, and improve patient outcomes, they are still too few in number to meet national needs for primary care. The COVID-19 pandemic revealed the extent of inadequacy and vulnerability of the system. The U. S. still lacks a system of universal access as has been in place for many years in most other advanced countries around the world. Corporate stakeholders in a largely privatized financing and delivery system continue to challenge the future of primary care. Lessons from the failure of reform...

The Journal of the Royal College of General Practitioners, 1982

Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 2012

Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. This article provides an overview of models supported by the Affordable Care Act that address one or more goals of the ''Triple Aim'': better health care for individuals, better health outcomes in the community, and lower health care costs. The models described below rely on the core principles of primary care: comprehensive, coordinated and continuous primary care; preventive care; and the sophisticated implementation of health information technology designed to promote communication between health care providers, enhance coordination of care, minimize duplication of services, and permit reporting on quality. These models will support better health care and reduced costs for people who access health care services but will not address health outcomes in the community at large. Health care professionals, working in concert with community-based organizations and advocates, must also address conditions that influence health in the broadest sense to truly improve the health of our communities and reduce health care costs. Mt Sinai J Med 79:527-534, 2012. © 2012 Mount Sinai School of Medicine

Health Affairs, 2010

Health Services Management Research, 1999

There is anecdotal evidence of a crisis in the recruitment and retention of general practitioners nationwide and particularly in inner cities. The relationship between quality of service and single-handed or group practice is uncertain and confounded by other aspects of practice structure and populations. The review examines the factors that influence doctors to enter and remain in general practice. It explores whether initiatives designed to address problems of recruitment and retention have been evaluated in the past and suggests how could they inform current initiatives.

New England Journal of Medicine, 2008

PubMed, 2001

, the College of General Practitioners was founded in London, establishing the first academic body for general practitioners in Europe. Golden jubilees are times for celebration and looking back, so better to judge the future. What has the College achieved? 1. College as a symbol. The College was founded as a symbol of the aspirations of thousands of GPs. It was a statement that GPs belonged in the family of medicine. The College was a unilateral declaration of professional independence. Fifty years later, the RCGP is the largest of all the 15 Medical Royal Colleges with great influence. 2. University role. General practice had been excluded from the universities. The new College surveyed the amount of training in general practice available to medical students and then campaigned for entry of GPs to the universities. Fifty years later, there are departments of primary care in every medical school and medical students are increasingly being taught in primary care by primary care colleagues. In 1952, there was not a single general practitioner professor in the world. Within 11 years of the College forming, the first chair was established in Edinburgh. The relatively small Council of the College provided the world s first professor and then the first professor of general practice in Canada, England, Ireland, and the first professor in a postgraduate university department general practice as well. 3. Vocational training. In 1952, there was no training for general practice. Doctors could go into practice without even doing a pre-registration year. Now there is a mandatory preregistration year and three years of postgraduate training for everyone, and the first GPs are doing 18 months in general practice. 4. Examinations in general practice. There was nothing in 1952 and now there is the MRCGP by examination, with the number of candidates approaching 2000 in some years. 5. Research. In 1952, general practitioner research consisted of a few brilliant individuals, such as Mackenzie and Pickles. We now have many more internationally known GP researchers. In addition, to the university departments, there are now NHS primary care research networks and NHS research general practices. The College funded the initial models for both in the early 1990s. 6. Research publications. In 1952, any general practice research had to be published in a general journal or a journal specialising in some other field. General practice research publications were fragmented. In 1961, the College Journal became the first primary care journal in the world to be included in Index Medicus and for the next 40 years led the primary care world in terms of impact factors. The RCGP Occasional Papers have entered the international literature and no other College has yet developed their equivalent. 7. Assessment in the practice. Fellowship of the College by Assessment, introduced in 1989, was the first College-run, on-site, practice-based assessment leading to a major professional award in the world. Based on published standards, judged by external peers and patient representatives, annually reviewed, and open to GPs as young as 33 and passed by a GP aged 65. FbA has led on to Membership by Assessment of performance, accredited professional development, and an acceptable system for revalidation by GPs. 8. International role. In 1952, GPs were internationally isolated. The RCGP first formed an international committee within its then Communications Division in 1982. It now plays an active part internationally, offers an MRCGP international, and holds the European WONCA Presidency. 9 Leadership of the medical profession. In 1952, the leadership of the medical profession was, had always been, and was expected to remain entirely in specialist hands. Now, the President of the GMC, the Chairman of the Academy of Medical Royal Colleges, the Chairman of the Council of the BMA, the Chairman of the Medical Postgraduate Deans, the Director of the London School of Tropical Medicine and Hygiene, and the Chief Medical Officer in Scotland are all general practitioners. The College has much to be proud of in its first 50 years, but will undoubtedly face great challenges in the next 50. Denis Pereira Gray contents 1026 miscellany Barefoot Redux, Ernst RCGP 50, highlights, Heath 1028 general practice in camera Single-handed-Donovan, Bain the rcgp at 50

Health Affairs, 1997

PROLOGUE: The policy world has been watching with interest the evolving relationships between physicians and managed care organizations. In the Summer 1996 issue of Health Affairs, David Blumenthal questioned the implications of competition for physicians and patient care. He argued that the administrative techniques that managed care organizations use to supervise physicians are a powerful force for change. He noted, however, that "evidence of the effectiveness of these techniques in reducing costs or improving quality is scant." Indeed, little is known about the direct implications for practice styles. This paper by Carol Simon and colleagues provides some initial indications of how, specifically, the partnering of physicians and managed care organizations is linked with differences in practice patterns. With increasing demand for primary care services, they ask, are there discernible differences in the scope of practice of primary care and specialist physicians? Simon and colleagues are well qualified to take on this question.

Postgraduate Medicine, 1993