This article extracts principles from two Surgeon General reports, "Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation" (2002) and "Call to Action to Improve the Health and Wellness of Persons with Disabilities" (2005), and combines them with the Objectives from "Chapter 6 of Healthy People 2010" to…

Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters…

Context: Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with…

Perceived control has become an important construct for health care research. Since the processes and outcomes of health and illness are constantly mediated and affected by communication, the relationship between a person's belief in his/her personal control of events and health care interactions is an important component of the theory and…

Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training…

Research has identified that while people with learning disabilities often have greater health needs than the general population, they access primary care at the same rate or lower. Valuing people recommends that members of learning disability teams should take on a key role in supporting people with learning disabilities to access mainstream…

A study in a medical center investigated the feasibility of primary care practices combining internal medicine and pediatrics residencies. Equally divided among children and adults, the patients had sought specialists and were highly satisfied. The physicians had appeal particularly to young upper-middle class patients. (Author/MSE)

In three decades, the osteopathic profession has moved from primarily manipulative therapy to full-service health care, replacing primary care emphasis with specialization. The profession should return to its original mission of primary care, establish links with allopathic medicine, and support new national policy for primary health care.…

Patient-centered strategies derived from the stages of change model, and motivational interviewing are used to develop a structured, teachable, and acceptable intervention for clinicians to help patients consider their smoking during general medical consultations. The method is described. Results for the model, tested on 270 smokers, are…

The aim of newborn screening is to identify presymptomatic healthy infants that will develop significant metabolic or endocrine derangements if left undiagnosed and untreated. The goal of ultimately reducing or eliminating irreversible sequelae is reached by maximizing test sensitivity of the primary newborn screening that measures specific…

One reason medical students favor specialization over generalist medicine (primary care) is a perception of generalist medicine as nonrigorous. Chaos science, a new field, reveals an intellectual basis for generalist medicine. The history, strengths, and limits of reductionist thinking in medicine and aspects of chaos theory illuminate this…

The progress of the child survival and development revolution (CSDR) from 1983 through 1986 is reviewed. The concept of the CSDR was first proposed in 1982 as a response to the need for low-cost, high-impact child health care measures during the global recession of the early 1980s. The report begins with a brief description of the relevance of the…

A combined B.S.-M.D. program designed to provide family practitioners to northwest Pennsylvania is described. The impact of the program on the region goes beyond the number of physicians supplied. Gannon University attracts high-quality students, and Erie hospitals benefit from affiliation with the medical school at Hahnemann University.…

An important potential contribution to the efficient use of the health workforce, is the possibility of "skill mix" changes. "Skill mix" is a relatively broad term which can refer to the mix of staff in the workforce or the demarcation of roles and activities among different categories of staff. Most of the policy attention on…

The definition of primary care is developed and a way is suggested to measure whether it is being achieved. Evaluative questions are identified that can determine whether a system of care is oriented toward primary care. They include assessing first-contact care, coordination of care, comprehensiveness, and longitudinality. (LBH)