This introduction to a journal supplement on education of the generalist physician describes the supplement's goal of capturing "in a qualitative way, the richness and complexity of primary care education and its place within the much larger context of health care and medical education reform." (JDD)

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)

Explored how primary care clinician-teachers actually attempt to convey empathy to medical students and residents. Found that they stress the centrality of role modeling in teaching, and most used debriefing strategies as well as both learner- and patient-centered approaches in instructing learners about empathy. (EV)

A study using microcomputer algorithms for more efficient management of six common pediatric care problems found improvements in all performance measures with computer algorithm use. However, use was discontinued after five weeks because the six physicians perceived the algorithms as too tedious for routine care. (Author/MSE)

A total of 200 patients were interviewed at 2 out-patient settings to quantify the patients' perspectives on their illness by measuring their requests for help. Results showed specific requests were made by most patients that focused either on the problem and/or the treatment. (GLR)

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.…

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)

A rigorous approach to conducting nonstatistical meta-analyses of research literature is presented and illustrated in a study of literature on primary care medical specialty choice. The approach described includes model development, literature retrieval and coding, quality rating, annotation of high-quality references, and synthesizing the subset…

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…

To provide medical students in community-based clinical settings with access to the same range of educational resources (medical literature, student colleagues, feedback, faculty) available at the academic medical center, this paper proposes that advancing information technology be applied to create a "virtual clinical campus" in the community…

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…

Medical schools are taking up the challenge to foster interest in the generalist fields. Issues in education of generalist physicians include the need for basic science teaching, more teaching in outpatient settings, difficulties of forecasting workforce needs, the challenge to generalist physician faculty, and the challenge of chronically…

Education of medical students in the basic and clinical sciences must be integrated into a seamless curriculum over four years, team-taught by both a clinician and a basic scientist. Medical students must be able to perform an initial evaluation of a neurological complaint and know when consultation is needed. (Author/MSE)

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)

The typical family practice residency program has been fiscally solvent as a result of receiving approximately one-third of its income from state and federal appropriations. Declining Medicare payments to hospitals threaten hospitals' contributions to family practice residency programs. (Author/MLW)