A point-counter-point analysis of increased dollar flows and the transformation of medical education is presented. Conclusions are drawn and recommendations are made regarding open issues in public policy, medical education, and the role of social institutions. (Author/LBH)

A program was devised at the Iowa College of Medicine to solicit volunteer mothers and their toddlers to help teach well-baby examinations. Peers were used to review the adequacy of the examination relative to specific anatomic-procedural items; the mothers evaluated the affectual aspect of the mother-student, child-student relationship. (LBH)

Describes national medical care services, in the Republic of Cuba, developed since the revolution of 1959. The comprehensive care polyclinic, basic unit for primary care services, is described in terms of human resources (teachers, medical personnel, other specialists) and functions (community health care, regionalization, provision of dispensary…

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…

Argues the need for a broad perspective in primary care policy, for government decision making to replace the normal market, for policy makers unafraid of controversy, for recognition of the difficulty of quantitative measurement of health care services, and for strong leadership including that from the academic sector. (JT)

New health practitioners (NHPs) are defined as nonphysician personnel being trained to carry out many tasks in the provision of primary care. The author traces historical background and legal issues involved in their training along with other policy issues and related problems, e.g. need for team training and practice. (JT)

Noting that family practice is increasingly accepted as part of the academic system, the author discusses its philosophy, overviews undergraduate programs and residency programs, presenting a sample curriculum outline for a 3-year family practice residency and emphasizing the need for continuity of care and a family practice office or center as a…

Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

Contending that many health care shortcomings derive from instructional programs, Jason Hilliare advocates reform in the student selection process, the human models available for emulation, the evaluation/reward system, and the instructional experiences available. J. D. Myers holds that quality insures stable and self-renewing undergraduate and…

Decentralized models of medical education, particularly for preparing primary care specialists, are increasing in importance as medical educators become aware of the need for medical students and residents to receive part of their clinical training away from the academic medical center in real practice settings. (Editor/PG)

This monograph is the result of a conference on the role of preventive and community medicine in primary medical care and education. The following six papers were presented at the conference: (1) Roles of Departments of Preventive Medicine; (2) Competency-Based Objectives in Preventive Medicine for the Family Physician; (3) Preventive Medicine…

Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…

When a private family practice in Hamilton, Canada, became a teaching practice of McMaster University, a before-and-after study was conducted to compare characteristics of the patients and the impact of the change on the practice. Conclusion: Such a transplanted private practice is a realistic teaching resource in primary care. (Editor/JT)