Examines how, as medical advances drastically reduced infant and child mortality rates, the field of pediatrics expanded from singular concern with treating children's diseases to include involvement in managing troublesome behavior. Considers the continued involvement of pediatricians in ministering to the psychosocial and behavioral needs of…

Surveys were mailed to a sample of Michigan internists and family practitioners (N=2060). This study examined influences on (1) how confident physicians feel about treating a particular problem, (2) where they look for assistance and advice, and (3) what level of continued involvement in the patient's care they prefer. (MLW)

General practitioners predominate in osteopathic as compared with allopathic medicine, perhaps because of the student selection process, features of osteopathic education, training in osteopathic hospitals, required rotating internship, and more high-quality general practitioner role models. Personality differences may account for differences in…

Medication noncompliance is seen as an obstacle to successful clinical outcomes of many diseases. An exercise for preclinical medical students at Stanford University is described. Objectives include sensitizing students to the consequences of medication noncompliance, illustrating problems, and evaluating a number of compliance-related issues.…

Further work is needed in identifying strategies to improve rural health services that are most appropriate and cost effective in regions with differing circumstances and needs. Substantial reform of payment systems favoring rural and primary care is essential to the effectiveness of educational reform. (Author/MSE)

Discussion of efforts to improve availability of primary health care in rural areas addresses student selection, curriculum, training environment, and special inducements, and controversial areas such as rural training sites, merging of specialties, and compromise of residency continuity. It is proposed that basic institutional philosophical…

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

Three factors that will have major effects on the medical cost quality debate are: industrial and governmental policy in regard to health-related expenditures, an aging population, and societal attitudes towards competition in the health care system. Approaches to conflict resolution are offered. (MLW)

Medical academic centers must adjust to a period of little or no real economic growth and make changes for continuing progress. Areas affected by the economic slowdown include policies regarding faculty private practice, the relationship between teaching hospitals and academic health centers, the production of primary care physicians, and the…

Discusses the effects of trends in health care services, including an emphasis on primary health care and patient involvement, on the information needs of health care professionals and managers. A proposed information network that would provide point of use access to sources of health care information is described. (three references) (CLB)

The objectives of this preliminary study were to evaluate the feasibility and acceptability of using trained simulated patient instructors (N=6) as an office-based continuing medical education method and to assess the current sexually transmitted diseases/human immunodeficiency virus risk assessment and counseling practices of primary care…

A questionnaire was administered to 339 graduating senior medical students at the Medical College of Georgia to determine different potential sources of influence on career choice. Indebtedness may be associated with the choice of a non-primary care specialty with greater remuneration than primary care specialty. (MLW)

It is proposed that medical schools recruit students from rural areas, have them choose family practice, and train them in rural settings. Specific recommendations for improving content and context of rural medical care education are made, including merging internal medicine, family practice, and pediatrics as a single primary care specialty.…

The decision-making experience of residents in a primary care internal medicine training practice was often inadequate. The residents' evaluation of their educational experience with patients suggests that several elements of patient care affected their ability to learn. (Author/GDC)

Clinical optometric education is in flux. It must meet the challenges of advances in bioscience, newer diagnostic and therapeutic modalities, a changing health care environment, and interdisciplinary learning for problem solving; engender social responsibility; promote good provider-patient relations; stress primary care; and emphasize prevention.…